How much rates vary
Facilitymedian $2,630 · 10th to 90th $891 to $7,586Professionalmedian $955 · 10th to 90th $562 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 $645.65 Median $4,168.69 Typical High $7,244.36 | Facility | None | $645.65 | $4,168.69 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $407.38 Median $645.65 Typical High $891.25 | Professional | None | $407.38 | $645.65 | $891.25 |
Cigna Setting Facility Modifier None Typical Low $1,096.48 Median $2,630.27 Typical High $3,235.94 | Facility | None | $1,096.48 | $2,630.27 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $912.01 Median $1,047.13 Typical High $1,318.26 | Professional | None | $912.01 | $1,047.13 | $1,318.26 |
Hally Health Setting Professional Modifier None Typical Low $371.54 Median $676.08 Typical High $1,148.15 | Professional | None | $371.54 | $676.08 | $1,148.15 |
Medica Setting Facility Modifier None Typical Low $812.83 Median $1,548.82 Typical High $7,413.10 | Facility | None | $812.83 | $1,548.82 | $7,413.10 |
Medica Setting Professional Modifier None Typical Low $660.69 Median $1,096.48 Typical High $4,265.80 | Professional | None | $660.69 | $1,096.48 | $4,265.80 |
Midlands Setting Professional Modifier None Typical Low $776.25 Median $1,071.52 Typical High $1,318.26 | Professional | None | $776.25 | $1,071.52 | $1,318.26 |
Midlands Setting Facility Modifier None Typical Low $1,621.81 Median $2,630.27 Typical High $3,235.94 | Facility | None | $1,621.81 | $2,630.27 | $3,235.94 |
Midlands Setting Professional Modifier None Typical Low $776.25 Median $1,122.02 Typical High $1,548.82 | Professional | None | $776.25 | $1,122.02 | $1,548.82 |
Oscar Health Setting Professional Modifier None Typical Low $416.87 Median $758.58 Typical High $1,202.26 | Professional | None | $416.87 | $758.58 | $1,202.26 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $3,630.78 Typical High $8,709.64 | Facility | None | $1,258.93 | $3,630.78 | $8,709.64 |
United Setting Professional Modifier None Typical Low $446.68 Median $724.44 Typical High $1,348.96 | Professional | None | $446.68 | $724.44 | $1,348.96 |
Wellmark Setting Professional Modifier None Typical Low $812.83 Median $954.99 Typical High $1,412.54 | Professional | None | $812.83 | $954.99 | $1,412.54 |
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 $204.17 Median $323.59 Typical High $436.52 | Professional | 52 · Reduced service | $204.17 | $323.59 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $128.82 Typical High $177.83 | Professional | 53 · Discontinued | $81.28 | $128.82 | $177.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $489.78 Typical High $660.69 | Professional | 54 · Surgery only | $309.03 | $489.78 | $660.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $97.72 Typical High $131.83 | Professional | 55 · Aftercare only | $61.66 | $97.72 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $64.57 Typical High $89.13 | Professional | 56 · Pre-op care only | $40.74 | $64.57 | $89.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $457.09 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $288.40 | $457.09 | $616.60 |
Where Iowa sits
The same service costs 5.8 times more in Alabama than in Montana. 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 $8,423MT $1,458
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.