How much rates vary
Facilitymedian $3,388 · 10th to 90th $1,259 to $11,482Professionalmedian $1,514 · 10th to 90th $933 to $2,630
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 $1,202.26 Median $3,090.30 Typical High $6,760.83 | Facility | None | $1,202.26 | $3,090.30 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $616.60 Median $954.99 Typical High $1,995.26 | Professional | None | $616.60 | $954.99 | $1,995.26 |
Cigna Setting Facility Modifier None Typical Low $1,380.38 Median $7,079.46 Typical High $9,332.54 | Facility | None | $1,380.38 | $7,079.46 | $9,332.54 |
Cigna Setting Professional Modifier None Typical Low $1,348.96 Median $1,698.24 Typical High $2,398.83 | Professional | None | $1,348.96 | $1,698.24 | $2,398.83 |
Hally Health Setting Professional Modifier None Typical Low $549.54 Median $1,258.93 Typical High $1,862.09 | Professional | None | $549.54 | $1,258.93 | $1,862.09 |
Medica Setting Facility Modifier None Typical Low $1,096.48 Median $2,511.89 Typical High $14,791.08 | Facility | None | $1,096.48 | $2,511.89 | $14,791.08 |
Medica Setting Professional Modifier None Typical Low $1,148.15 Median $1,778.28 Typical High $7,585.78 | Professional | None | $1,148.15 | $1,778.28 | $7,585.78 |
Midlands Setting Professional Modifier None Typical Low $1,148.15 Median $1,905.46 Typical High $2,344.23 | Professional | None | $1,148.15 | $1,905.46 | $2,344.23 |
Midlands Setting Facility Modifier None Typical Low $1,905.46 Median $6,606.93 Typical High $9,332.54 | Facility | None | $1,905.46 | $6,606.93 | $9,332.54 |
Midlands Setting Professional Modifier None Typical Low $1,318.26 Median $1,995.26 Typical High $2,754.23 | Professional | None | $1,318.26 | $1,995.26 | $2,754.23 |
Oscar Health Setting Professional Modifier None Typical Low $616.60 Median $1,174.90 Typical High $2,187.76 | Professional | None | $616.60 | $1,174.90 | $2,187.76 |
United Setting Facility Modifier None Typical Low $1,380.38 Median $4,786.30 Typical High $19,054.61 | Facility | None | $1,380.38 | $4,786.30 | $19,054.61 |
United Setting Professional Modifier None Typical Low $676.08 Median $1,174.90 Typical High $2,398.83 | Professional | None | $676.08 | $1,174.90 | $2,398.83 |
Wellmark Setting Professional Modifier None Typical Low $1,174.90 Median $1,380.38 Typical High $2,570.40 | Professional | None | $1,174.90 | $1,380.38 | $2,570.40 |
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 $302.00 Median $478.63 Typical High $794.33 | Professional | 52 · Reduced service | $302.00 | $478.63 | $794.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $190.55 Typical High $316.23 | Professional | 53 · Discontinued | $120.23 | $190.55 | $316.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $724.44 Typical High $1,174.90 | Professional | 54 · Surgery only | $457.09 | $724.44 | $1,174.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $144.54 Typical High $234.42 | Professional | 55 · Aftercare only | $91.20 | $144.54 | $234.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $95.50 Typical High $158.49 | Professional | 56 · Pre-op care only | $60.26 | $95.50 | $158.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $676.08 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $426.58 | $676.08 | $1,096.48 |
Where Iowa sits
The same service costs 5.1 times more in Alaska than in West Virginia. 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
AK $10,217WV $2,002
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.