How much rates vary
Facilitymedian $339 · 10th to 90th $135 to $2,291Professionalmedian $224 · 10th to 90th $120 to $363
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 $199.53 Median $2,630.27 Typical High $6,760.83 | Facility | None | $199.53 | $2,630.27 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $89.13 Median $151.36 Typical High $199.53 | Professional | None | $89.13 | $151.36 | $199.53 |
Cigna Setting Facility Modifier None Typical Low $107.15 Median $147.91 Typical High $208.93 | Facility | None | $107.15 | $147.91 | $208.93 |
Cigna Setting Professional Modifier None Typical Low $199.53 Median $229.09 Typical High $302.00 | Professional | None | $199.53 | $229.09 | $302.00 |
Hally Health Setting Professional Modifier None Typical Low $87.10 Median $158.49 Typical High $223.87 | Professional | None | $87.10 | $158.49 | $223.87 |
Medica Setting Facility Modifier None Typical Low $147.91 Median $275.42 Typical High $1,288.25 | Facility | None | $147.91 | $275.42 | $1,288.25 |
Medica Setting Professional Modifier None Typical Low $134.90 Median $275.42 Typical High $954.99 | Professional | None | $134.90 | $275.42 | $954.99 |
Midlands Setting Professional Modifier None Typical Low $181.97 Median $239.88 Typical High $281.84 | Professional | None | $181.97 | $239.88 | $281.84 |
Midlands Setting Facility Modifier None Typical Low $104.71 Median $147.91 Typical High $208.93 | Facility | None | $104.71 | $147.91 | $208.93 |
Midlands Setting Professional Modifier None Typical Low $169.82 Median $257.04 Typical High $346.74 | Professional | None | $169.82 | $257.04 | $346.74 |
Oscar Health Setting Professional Modifier None Typical Low $109.65 Median $204.17 Typical High $316.23 | Professional | None | $109.65 | $204.17 | $316.23 |
United Setting Facility Modifier None Typical Low $223.87 Median $707.95 Typical High $1,995.26 | Facility | None | $223.87 | $707.95 | $1,995.26 |
United Setting Professional Modifier None Typical Low $97.72 Median $154.88 Typical High $288.40 | Professional | None | $97.72 | $154.88 | $288.40 |
Wellmark Setting Professional Modifier None Typical Low $208.93 Median $245.47 Typical High $363.08 | Professional | None | $208.93 | $245.47 | $363.08 |
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 $47.86 Median $74.13 Typical High $100.00 | Professional | 52 · Reduced service | $47.86 | $74.13 | $100.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.05 Median $30.20 Typical High $40.74 | Professional | 53 · Discontinued | $19.05 | $30.20 | $40.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $70.79 Median $112.20 Typical High $151.36 | Professional | 54 · Surgery only | $70.79 | $112.20 | $151.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.13 Median $22.39 Typical High $30.20 | Professional | 55 · Aftercare only | $14.13 | $22.39 | $30.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.55 Median $15.14 Typical High $19.95 | Professional | 56 · Pre-op care only | $9.55 | $15.14 | $19.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $66.07 Median $104.71 Typical High $141.25 | Professional | 78 · Unplanned return to OR | $66.07 | $104.71 | $141.25 |
Where Iowa sits
The same service costs 13.1 times more in Hawaii than in Maryland. 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
HI $2,944MD $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.