How much rates vary
Facilitymedian $3,467 · 10th to 90th $1,259 to $9,772Professionalmedian $1,778 · 10th to 90th $977 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 $1,288.25 Median $5,888.44 Typical High $11,481.54 | Facility | None | $1,288.25 | $5,888.44 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $741.31 Median $1,288.25 Typical High $1,288.25 | Professional | None | $741.31 | $1,288.25 | $1,288.25 |
Cigna Setting Facility Modifier None Typical Low $2,454.71 Median $3,090.30 Typical High $3,467.37 | Facility | None | $2,454.71 | $3,090.30 | $3,467.37 |
Cigna Setting Professional Modifier None Typical Low $1,659.59 Median $1,862.09 Typical High $2,290.87 | Professional | None | $1,659.59 | $1,862.09 | $2,290.87 |
Hally Health Setting Professional Modifier None Typical Low $758.58 Median $1,288.25 Typical High $2,398.83 | Professional | None | $758.58 | $1,288.25 | $2,398.83 |
Medica Setting Facility Modifier None Typical Low $1,258.93 Median $2,238.72 Typical High $9,332.54 | Facility | None | $1,258.93 | $2,238.72 | $9,332.54 |
Medica Setting Professional Modifier None Typical Low $977.24 Median $1,819.70 Typical High $6,165.95 | Professional | None | $977.24 | $1,819.70 | $6,165.95 |
Midlands Setting Professional Modifier None Typical Low $1,584.89 Median $1,862.09 Typical High $2,290.87 | Professional | None | $1,584.89 | $1,862.09 | $2,290.87 |
Midlands Setting Facility Modifier None Typical Low $2,454.71 Median $3,090.30 Typical High $3,467.37 | Facility | None | $2,454.71 | $3,090.30 | $3,467.37 |
Midlands Setting Professional Modifier None Typical Low $1,698.24 Median $1,819.70 Typical High $3,019.95 | Professional | None | $1,698.24 | $1,819.70 | $3,019.95 |
United Setting Facility Modifier None Typical Low $1,819.70 Median $5,495.41 Typical High $11,220.18 | Facility | None | $1,819.70 | $5,495.41 | $11,220.18 |
United Setting Professional Modifier None Typical Low $851.14 Median $1,288.25 Typical High $2,344.23 | Professional | None | $851.14 | $1,288.25 | $2,344.23 |
Wellmark Setting Professional Modifier None Typical Low $1,584.89 Median $1,584.89 Typical High $1,862.09 | Professional | None | $1,584.89 | $1,584.89 | $1,862.09 |
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 $371.54 Median $630.96 Typical High $630.96 | Professional | 52 · Reduced service | $371.54 | $630.96 | $630.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $257.04 Typical High $257.04 | Professional | 53 · Discontinued | $147.91 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $954.99 Typical High $954.99 | Professional | 54 · Surgery only | $549.54 | $954.99 | $954.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $190.55 Typical High $190.55 | Professional | 55 · Aftercare only | $109.65 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $128.82 Typical High $128.82 | Professional | 56 · Pre-op care only | $74.13 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $891.25 Typical High $891.25 | Professional | 78 · Unplanned return to OR | $512.86 | $891.25 | $891.25 |
Where Iowa sits
The same service costs 5.0 times more in Alabama than in Kentucky. 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
AL $11,256KY $2,261
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.