How much rates vary
Facilitymedian $135 · 10th to 90th $95 to $234Professionalmedian $219 · 10th to 90th $110 to $331
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 $91.20 Median $120.23 Typical High $4,365.16 | Facility | None | $91.20 | $120.23 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $79.43 Median $95.50 Typical High $128.82 | Professional | None | $79.43 | $95.50 | $128.82 |
Cigna Setting Facility Modifier None Typical Low $85.11 Median $112.20 Typical High $234.42 | Facility | None | $85.11 | $112.20 | $234.42 |
Cigna Setting Professional Modifier None Typical Low $173.78 Median $229.09 Typical High $302.00 | Professional | None | $173.78 | $229.09 | $302.00 |
Medica Setting Facility Modifier None Typical Low $123.03 Median $151.36 Typical High $223.87 | Facility | None | $123.03 | $151.36 | $223.87 |
Medica Setting Professional Modifier None Typical Low $104.71 Median $288.40 Typical High $954.99 | Professional | None | $104.71 | $288.40 | $954.99 |
Midlands Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $269.15 | Professional | None | $204.17 | $204.17 | $269.15 |
Midlands Setting Facility Modifier None Typical Low $85.11 Median $112.20 Typical High $162.18 | Facility | None | $85.11 | $112.20 | $162.18 |
Midlands Setting Professional Modifier None Typical Low $186.21 Median $199.53 Typical High $263.03 | Professional | None | $186.21 | $199.53 | $263.03 |
Sanford Health Plan Setting Professional Modifier None Typical Low $120.23 Median $177.83 Typical High $251.19 | Professional | None | $120.23 | $177.83 | $251.19 |
United Setting Facility Modifier None Typical Low $125.89 Median $125.89 Typical High $223.87 | Facility | None | $125.89 | $125.89 | $223.87 |
United Setting Professional Modifier None Typical Low $100.00 Median $234.42 Typical High $331.13 | Professional | None | $100.00 | $234.42 | $331.13 |
Wellmark Setting Professional Modifier None Typical Low $218.78 Median $257.04 Typical High $380.19 | Professional | None | $218.78 | $257.04 | $380.19 |
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 $39.81 Median $54.95 Typical High $64.57 | Professional | 52 · Reduced service | $39.81 | $54.95 | $64.57 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.85 Median $21.88 Typical High $25.70 | Professional | 53 · Discontinued | $15.85 | $21.88 | $25.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $60.26 Median $81.28 Typical High $97.72 | Professional | 54 · Surgery only | $60.26 | $81.28 | $97.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $16.22 Typical High $19.50 | Professional | 55 · Aftercare only | $12.02 | $16.22 | $19.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $10.96 Typical High $12.88 | Professional | 56 · Pre-op care only | $7.94 | $10.96 | $12.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $56.23 Median $75.86 Typical High $91.20 | Professional | 78 · Unplanned return to OR | $56.23 | $75.86 | $91.20 |
Where South Dakota 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.