How much rates vary
Facilitymedian $3,631 · 10th to 90th $776 to $14,791Professionalmedian $813 · 10th to 90th $427 to $1,096
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 $630.96 Median $4,265.80 Typical High $7,244.36 | Facility | None | $630.96 | $4,265.80 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $363.08 Median $630.96 Typical High $630.96 | Professional | None | $363.08 | $630.96 | $630.96 |
Cigna Setting Facility Modifier None Typical Low $1,096.48 Median $5,888.44 Typical High $7,244.36 | Facility | None | $1,096.48 | $5,888.44 | $7,244.36 |
Cigna Setting Professional Modifier None Typical Low $758.58 Median $912.01 Typical High $1,071.52 | Professional | None | $758.58 | $912.01 | $1,071.52 |
Hally Health Setting Professional Modifier None Typical Low $363.08 Median $549.54 Typical High $933.25 | Professional | None | $363.08 | $549.54 | $933.25 |
Medica Setting Facility Modifier None Typical Low $660.69 Median $1,659.59 Typical High $17,378.01 | Facility | None | $660.69 | $1,659.59 | $17,378.01 |
Medica Setting Professional Modifier None Typical Low $436.52 Median $891.25 Typical High $3,630.78 | Professional | None | $436.52 | $891.25 | $3,630.78 |
Midlands Setting Professional Modifier None Typical Low $776.25 Median $891.25 Typical High $1,047.13 | Professional | None | $776.25 | $891.25 | $1,047.13 |
Midlands Setting Facility Modifier None Typical Low $1,862.09 Median $5,888.44 Typical High $7,244.36 | Facility | None | $1,862.09 | $5,888.44 | $7,244.36 |
Midlands Setting Professional Modifier None Typical Low $741.31 Median $933.25 Typical High $1,174.90 | Professional | None | $741.31 | $933.25 | $1,174.90 |
Oscar Health Setting Professional Modifier None Typical Low $389.05 Median $724.44 Typical High $891.25 | Professional | None | $389.05 | $724.44 | $891.25 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $3,630.78 Typical High $19,054.61 | Facility | None | $1,258.93 | $3,630.78 | $19,054.61 |
United Setting Professional Modifier None Typical Low $380.19 Median $588.84 Typical High $1,047.13 | Professional | None | $380.19 | $588.84 | $1,047.13 |
Wellmark Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $954.99 | Professional | None | $812.83 | $812.83 | $954.99 |
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 $316.23 Typical High $316.23 | Professional | 52 · Reduced service | $181.97 | $316.23 | $316.23 |
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 $275.42 Median $467.74 Typical High $467.74 | Professional | 54 · Surgery only | $275.42 | $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 $63.10 Typical High $63.10 | Professional | 56 · Pre-op care only | $36.31 | $63.10 | $63.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $257.04 Median $436.52 Typical High $436.52 | Professional | 78 · Unplanned return to OR | $257.04 | $436.52 | $436.52 |
Where Iowa sits
The same service costs 7.2 times more in Alaska 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.
Iowa· 5th of 51
$891
AK $1,622TX $224
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.