How much rates vary
Facilitymedian $3,090 · 10th to 90th $1,047 to $8,710Professionalmedian $1,175 · 10th to 90th $617 to $1,549
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $851.14 Median $4,265.80 Typical High $7,244.36 | Facility | None | $851.14 | $4,265.80 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $489.78 Median $851.14 Typical High $851.14 | Professional | None | $489.78 | $851.14 | $851.14 |
Cigna Setting Facility Modifier None Typical Low $1,096.48 Median $2,630.27 Typical High $3,235.94 | Facility | None | $1,096.48 | $2,630.27 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $1,071.52 Median $1,202.26 Typical High $1,445.44 | Professional | None | $1,071.52 | $1,202.26 | $1,445.44 |
Hally Health Setting Professional Modifier None Typical Low $489.78 Median $851.14 Typical High $1,584.89 | Professional | None | $489.78 | $851.14 | $1,584.89 |
Medica Setting Facility Modifier None Typical Low $1,000.00 Median $2,344.23 Typical High $8,912.51 | Facility | None | $1,000.00 | $2,344.23 | $8,912.51 |
Medica Setting Professional Modifier None Typical Low $616.60 Median $1,258.93 Typical High $5,128.61 | Professional | None | $616.60 | $1,258.93 | $5,128.61 |
Midlands Setting Professional Modifier None Typical Low $1,023.29 Median $1,202.26 Typical High $1,445.44 | Professional | None | $1,023.29 | $1,202.26 | $1,445.44 |
Midlands Setting Facility Modifier None Typical Low $1,621.81 Median $2,630.27 Typical High $3,235.94 | Facility | None | $1,621.81 | $2,630.27 | $3,235.94 |
Midlands Setting Professional Modifier None Typical Low $1,071.52 Median $1,230.27 Typical High $1,995.26 | Professional | None | $1,071.52 | $1,230.27 | $1,995.26 |
Oscar Health Setting Professional Modifier None Typical Low $512.86 Median $954.99 Typical High $1,174.90 | Professional | None | $512.86 | $954.99 | $1,174.90 |
United Setting Facility Modifier None Typical Low $1,380.38 Median $4,365.16 Typical High $9,772.37 | Facility | None | $1,380.38 | $4,365.16 | $9,772.37 |
United Setting Professional Modifier None Typical Low $537.03 Median $831.76 Typical High $1,513.56 | Professional | None | $537.03 | $831.76 | $1,513.56 |
Wellmark Setting Professional Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $1,230.27 | Professional | None | $1,047.13 | $1,047.13 | $1,230.27 |
6 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $245.47 Median $426.58 Typical High $426.58 | Professional | 52 · Reduced service | $245.47 | $426.58 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $169.82 Typical High $169.82 | Professional | 53 · Discontinued | $97.72 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $630.96 Typical High $630.96 | Professional | 54 · Surgery only | $371.54 | $630.96 | $630.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $125.89 Typical High $125.89 | Professional | 55 · Aftercare only | $74.13 | $125.89 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $85.11 Typical High $85.11 | Professional | 56 · Pre-op care only | $48.98 | $85.11 | $85.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $346.74 Median $588.84 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $346.74 | $588.84 | $588.84 |
Where Iowa sits
The same service costs 4.3 times more in Wisconsin than in Montana. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Physician feeFacility fee
WI $7,406MT $1,722
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.