How much rates vary
Facilitymedian $5,370 · 10th to 90th $1,585 to $24,547Professionalmedian $1,738 · 10th to 90th $955 to $2,455
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 $1,412.54 Median $4,786.30 Typical High $7,244.36 | Facility | None | $1,412.54 | $4,786.30 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $812.83 Median $1,412.54 Typical High $1,819.70 | Professional | None | $812.83 | $1,412.54 | $1,819.70 |
Cigna Setting Facility Modifier None Typical Low $1,288.25 Median $15,135.61 Typical High $18,620.87 | Facility | None | $1,288.25 | $15,135.61 | $18,620.87 |
Cigna Setting Professional Modifier None Typical Low $1,737.80 Median $2,041.74 Typical High $2,454.71 | Professional | None | $1,737.80 | $2,041.74 | $2,454.71 |
Hally Health Setting Professional Modifier None Typical Low $831.76 Median $1,380.38 Typical High $2,344.23 | Professional | None | $831.76 | $1,380.38 | $2,344.23 |
Medica Setting Facility Modifier None Typical Low $1,584.89 Median $4,677.35 Typical High $26,302.68 | Facility | None | $1,584.89 | $4,677.35 | $26,302.68 |
Medica Setting Professional Modifier None Typical Low $1,023.29 Median $1,995.26 Typical High $6,606.93 | Professional | None | $1,023.29 | $1,995.26 | $6,606.93 |
Midlands Setting Professional Modifier None Typical Low $1,737.80 Median $2,041.74 Typical High $2,454.71 | Professional | None | $1,737.80 | $2,041.74 | $2,454.71 |
Midlands Setting Facility Modifier None Typical Low $3,548.13 Median $14,125.38 Typical High $18,620.87 | Facility | None | $3,548.13 | $14,125.38 | $18,620.87 |
Midlands Setting Professional Modifier None Typical Low $1,737.80 Median $1,995.26 Typical High $3,019.95 | Professional | None | $1,737.80 | $1,995.26 | $3,019.95 |
Oscar Health Setting Professional Modifier None Typical Low $851.14 Median $1,584.89 Typical High $1,995.26 | Professional | None | $851.14 | $1,584.89 | $1,995.26 |
United Setting Facility Modifier None Typical Low $1,819.70 Median $6,309.57 Typical High $33,884.42 | Facility | None | $1,819.70 | $6,309.57 | $33,884.42 |
United Setting Professional Modifier None Typical Low $891.25 Median $1,348.96 Typical High $2,454.71 | Professional | None | $891.25 | $1,348.96 | $2,454.71 |
Wellmark Setting Professional Modifier None Typical Low $1,737.80 Median $1,737.80 Typical High $2,041.74 | Professional | None | $1,737.80 | $1,737.80 | $2,041.74 |
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 $407.38 Median $707.95 Typical High $707.95 | Professional | 52 · Reduced service | $407.38 | $707.95 | $707.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $281.84 Typical High $281.84 | Professional | 53 · Discontinued | $162.18 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $1,047.13 Typical High $1,047.13 | Professional | 54 · Surgery only | $616.60 | $1,047.13 | $1,047.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $213.80 Typical High $213.80 | Professional | 55 · Aftercare only | $123.03 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $141.25 Typical High $141.25 | Professional | 56 · Pre-op care only | $81.28 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $977.24 Typical High $977.24 | Professional | 78 · Unplanned return to OR | $575.44 | $977.24 | $977.24 |
Where Iowa sits
The same service costs 6.8 times more in Alaska 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
AK $19,480MT $2,858
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.