How much rates vary
Facilitymedian $646 · 10th to 90th $200 to $2,512Professionalmedian $871 · 10th to 90th $427 to $1,122
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 $616.60 Median $2,754.23 Typical High $6,760.83 | Facility | None | $616.60 | $2,754.23 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $363.08 Median $616.60 Typical High $891.25 | Professional | None | $363.08 | $616.60 | $891.25 |
Cigna Setting Facility Modifier None Typical Low $114.82 Median $223.87 Typical High $316.23 | Facility | None | $114.82 | $223.87 | $316.23 |
Cigna Setting Professional Modifier None Typical Low $724.44 Median $912.01 Typical High $1,096.48 | Professional | None | $724.44 | $912.01 | $1,096.48 |
Hally Health Setting Professional Modifier None Typical Low $363.08 Median $537.03 Typical High $912.01 | Professional | None | $363.08 | $537.03 | $912.01 |
Medica Setting Facility Modifier None Typical Low $229.09 Median $724.44 Typical High $1,778.28 | Facility | None | $229.09 | $724.44 | $1,778.28 |
Medica Setting Professional Modifier None Typical Low $416.87 Median $812.83 Typical High $2,951.21 | Professional | None | $416.87 | $812.83 | $2,951.21 |
Midlands Setting Professional Modifier None Typical Low $776.25 Median $851.14 Typical High $1,096.48 | Professional | None | $776.25 | $851.14 | $1,096.48 |
Midlands Setting Facility Modifier None Typical Low $123.03 Median $223.87 Typical High $316.23 | Facility | None | $123.03 | $223.87 | $316.23 |
Midlands Setting Professional Modifier None Typical Low $707.95 Median $1,096.48 Typical High $1,148.15 | Professional | None | $707.95 | $1,096.48 | $1,148.15 |
Oscar Health Setting Professional Modifier None Typical Low $446.68 Median $831.76 Typical High $1,047.13 | Professional | None | $446.68 | $831.76 | $1,047.13 |
United Setting Facility Modifier None Typical Low $223.87 Median $707.95 Typical High $1,995.26 | Facility | None | $223.87 | $707.95 | $1,995.26 |
United Setting Professional Modifier None Typical Low $371.54 Median $562.34 Typical High $1,023.29 | Professional | None | $371.54 | $562.34 | $1,023.29 |
Wellmark Setting Professional Modifier None Typical Low $954.99 Median $954.99 Typical High $1,122.02 | Professional | None | $954.99 | $954.99 | $1,122.02 |
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 $181.97 Median $309.03 Typical High $309.03 | Professional | 52 · Reduced service | $181.97 | $309.03 | $309.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $72.44 Median $125.89 Typical High $125.89 | Professional | 53 · Discontinued | $72.44 | $125.89 | $125.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $269.15 Median $467.74 Typical High $467.74 | Professional | 54 · Surgery only | $269.15 | $467.74 | $467.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $93.33 Typical High $93.33 | Professional | 55 · Aftercare only | $54.95 | $93.33 | $93.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $61.66 Typical High $61.66 | Professional | 56 · Pre-op care only | $36.31 | $61.66 | $61.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $251.19 Median $436.52 Typical High $436.52 | Professional | 78 · Unplanned return to OR | $251.19 | $436.52 | $436.52 |
Where Iowa sits
The same service costs 6.4 times more in Connecticut than in Texas. 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
CT $3,322TX $515
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.