How much rates vary
Facilitymedian $1,514 · 10th to 90th $813 to $5,012Professionalmedian $1,122 · 10th to 90th $589 to $1,479
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 $794.33 Median $3,388.44 Typical High $6,760.83 | Facility | None | $794.33 | $3,388.44 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $489.78 Median $794.33 Typical High $870.96 | Professional | None | $489.78 | $794.33 | $870.96 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $1,445.44 Typical High $1,698.24 | Facility | None | $954.99 | $1,445.44 | $1,698.24 |
Cigna Setting Professional Modifier None Typical Low $1,047.13 Median $1,202.26 Typical High $1,412.54 | Professional | None | $1,047.13 | $1,202.26 | $1,412.54 |
Hally Health Setting Professional Modifier None Typical Low $467.74 Median $776.25 Typical High $1,122.02 | Professional | None | $467.74 | $776.25 | $1,122.02 |
Medica Setting Facility Modifier None Typical Low $812.83 Median $1,380.38 Typical High $4,786.30 | Facility | None | $812.83 | $1,380.38 | $4,786.30 |
Medica Setting Professional Modifier None Typical Low $660.69 Median $1,230.27 Typical High $4,073.80 | Professional | None | $660.69 | $1,230.27 | $4,073.80 |
Midlands Setting Professional Modifier None Typical Low $977.24 Median $1,148.15 Typical High $1,380.38 | Professional | None | $977.24 | $1,148.15 | $1,380.38 |
Midlands Setting Facility Modifier None Typical Low $954.99 Median $1,445.44 Typical High $1,698.24 | Facility | None | $954.99 | $1,445.44 | $1,698.24 |
Midlands Setting Professional Modifier None Typical Low $954.99 Median $1,380.38 Typical High $1,513.56 | Professional | None | $954.99 | $1,380.38 | $1,513.56 |
Oscar Health Setting Professional Modifier None Typical Low $524.81 Median $977.24 Typical High $1,318.26 | Professional | None | $524.81 | $977.24 | $1,318.26 |
United Setting Facility Modifier None Typical Low $724.44 Median $2,884.03 Typical High $5,495.41 | Facility | None | $724.44 | $2,884.03 | $5,495.41 |
United Setting Professional Modifier None Typical Low $512.86 Median $776.25 Typical High $1,445.44 | Professional | None | $512.86 | $776.25 | $1,445.44 |
Wellmark Setting Professional Modifier None Typical Low $1,000.00 Median $1,174.90 Typical High $1,479.11 | Professional | None | $1,000.00 | $1,174.90 | $1,479.11 |
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 $251.19 Median $398.11 Typical High $436.52 | Professional | 52 · Reduced service | $251.19 | $398.11 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $158.49 Typical High $177.83 | Professional | 53 · Discontinued | $100.00 | $158.49 | $177.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $588.84 Typical High $660.69 | Professional | 54 · Surgery only | $371.54 | $588.84 | $660.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $117.49 Typical High $131.83 | Professional | 55 · Aftercare only | $74.13 | $117.49 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $79.43 Typical High $87.10 | Professional | 56 · Pre-op care only | $50.12 | $79.43 | $87.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $346.74 Median $549.54 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $346.74 | $549.54 | $616.60 |
Where Iowa sits
The same service costs 4.0 times more in Colorado than in Alabama. 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 $5,057AL $1,277
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.