How much rates vary
Facilitymedian $5,248 · 10th to 90th $1,514 to $15,136Professionalmedian $1,738 · 10th to 90th $933 to $2,399
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 $1,380.38 Median $3,548.13 Typical High $6,760.83 | Facility | None | $1,380.38 | $3,548.13 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $794.33 Median $1,380.38 Typical High $2,089.30 | Professional | None | $794.33 | $1,380.38 | $2,089.30 |
Cigna Setting Facility Modifier None Typical Low $1,096.48 Median $7,943.28 Typical High $9,332.54 | Facility | None | $1,096.48 | $7,943.28 | $9,332.54 |
Cigna Setting Professional Modifier None Typical Low $1,659.59 Median $1,995.26 Typical High $2,398.83 | Professional | None | $1,659.59 | $1,995.26 | $2,398.83 |
Hally Health Setting Professional Modifier None Typical Low $794.33 Median $1,288.25 Typical High $2,454.71 | Professional | None | $794.33 | $1,288.25 | $2,454.71 |
Medica Setting Facility Modifier None Typical Low $1,513.56 Median $4,677.35 Typical High $17,378.01 | Facility | None | $1,513.56 | $4,677.35 | $17,378.01 |
Medica Setting Professional Modifier None Typical Low $977.24 Median $1,949.84 Typical High $6,456.54 | Professional | None | $977.24 | $1,949.84 | $6,456.54 |
Midlands Setting Professional Modifier None Typical Low $1,698.24 Median $1,949.84 Typical High $2,344.23 | Professional | None | $1,698.24 | $1,949.84 | $2,344.23 |
Midlands Setting Facility Modifier None Typical Low $3,548.13 Median $7,762.47 Typical High $9,332.54 | Facility | None | $3,548.13 | $7,762.47 | $9,332.54 |
Midlands Setting Professional Modifier None Typical Low $1,621.81 Median $1,995.26 Typical High $3,090.30 | Professional | None | $1,621.81 | $1,995.26 | $3,090.30 |
Oscar Health Setting Professional Modifier None Typical Low $831.76 Median $1,548.82 Typical High $1,949.84 | Professional | None | $831.76 | $1,548.82 | $1,949.84 |
United Setting Facility Modifier None Typical Low $1,819.70 Median $6,309.57 Typical High $19,054.61 | Facility | None | $1,819.70 | $6,309.57 | $19,054.61 |
United Setting Professional Modifier None Typical Low $851.14 Median $1,318.26 Typical High $2,398.83 | Professional | None | $851.14 | $1,318.26 | $2,398.83 |
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 $398.11 Median $691.83 Typical High $691.83 | Professional | 52 · Reduced service | $398.11 | $691.83 | $691.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $275.42 Typical High $275.42 | Professional | 53 · Discontinued | $158.49 | $275.42 | $275.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $602.56 Median $1,023.29 Typical High $1,023.29 | Professional | 54 · Surgery only | $602.56 | $1,023.29 | $1,023.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $204.17 Typical High $204.17 | Professional | 55 · Aftercare only | $120.23 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $138.04 Typical High $138.04 | Professional | 56 · Pre-op care only | $79.43 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $562.34 Median $954.99 Typical High $954.99 | Professional | 78 · Unplanned return to OR | $562.34 | $954.99 | $954.99 |
Where Iowa sits
The same service costs 5.5 times more in Colorado than in Hawaii. 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
CO $14,085HI $2,567
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.