How much rates vary
Facilitymedian $3,467 · 10th to 90th $1,000 to $9,772Professionalmedian $1,413 · 10th to 90th $741 to $1,820
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 $1,000.00 Median $5,888.44 Typical High $7,943.28 | Facility | None | $1,000.00 | $5,888.44 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $575.44 Median $1,000.00 Typical High $1,000.00 | Professional | None | $575.44 | $1,000.00 | $1,000.00 |
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 $1,258.93 Median $1,445.44 Typical High $1,778.28 | Professional | None | $1,258.93 | $1,445.44 | $1,778.28 |
Hally Health Setting Professional Modifier None Typical Low $602.56 Median $977.24 Typical High $1,778.28 | Professional | None | $602.56 | $977.24 | $1,778.28 |
Medica Setting Facility Modifier None Typical Low $977.24 Median $1,737.80 Typical High $9,332.54 | Facility | None | $977.24 | $1,737.80 | $9,332.54 |
Medica Setting Professional Modifier None Typical Low $741.31 Median $1,412.54 Typical High $4,786.30 | Professional | None | $741.31 | $1,412.54 | $4,786.30 |
Midlands Setting Professional Modifier None Typical Low $1,230.27 Median $1,445.44 Typical High $1,778.28 | Professional | None | $1,230.27 | $1,445.44 | $1,778.28 |
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 $1,288.25 Median $1,445.44 Typical High $2,290.87 | Professional | None | $1,288.25 | $1,445.44 | $2,290.87 |
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 $645.65 Median $977.24 Typical High $1,778.28 | Professional | None | $645.65 | $977.24 | $1,778.28 |
Wellmark Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,479.11 | Professional | None | $1,258.93 | $1,258.93 | $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 $288.40 Median $501.19 Typical High $501.19 | Professional | 52 · Reduced service | $288.40 | $501.19 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $114.82 Median $199.53 Typical High $199.53 | Professional | 53 · Discontinued | $114.82 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $436.52 Median $758.58 Typical High $758.58 | Professional | 54 · Surgery only | $436.52 | $758.58 | $758.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $87.10 Median $151.36 Typical High $151.36 | Professional | 55 · Aftercare only | $87.10 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $100.00 Typical High $100.00 | Professional | 56 · Pre-op care only | $57.54 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $407.38 Median $707.95 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $407.38 | $707.95 | $707.95 |
Where Iowa sits
The same service costs 7.6 times more in Oklahoma 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
OK $11,248TX $1,472
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.