How much rates vary
Facilitymedian $3,090 · 10th to 90th $1,000 to $8,710Professionalmedian $1,047 · 10th to 90th $603 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 $831.76 Median $4,265.80 Typical High $7,244.36 | Facility | None | $831.76 | $4,265.80 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $489.78 Median $831.76 Typical High $1,258.93 | Professional | None | $489.78 | $831.76 | $1,258.93 |
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 $1,023.29 Median $1,202.26 Typical High $1,479.11 | Professional | None | $1,023.29 | $1,202.26 | $1,479.11 |
Hally Health Setting Professional Modifier None Typical Low $478.63 Median $794.33 Typical High $1,479.11 | Professional | None | $478.63 | $794.33 | $1,479.11 |
Medica Setting Facility Modifier None Typical Low $933.25 Median $2,344.23 Typical High $8,912.51 | Facility | None | $933.25 | $2,344.23 | $8,912.51 |
Medica Setting Professional Modifier None Typical Low $602.56 Median $1,174.90 Typical High $4,265.80 | Professional | None | $602.56 | $1,174.90 | $4,265.80 |
Midlands Setting Professional Modifier None Typical Low $1,023.29 Median $1,202.26 Typical High $1,445.44 | Professional | None | $1,023.29 | $1,202.26 | $1,445.44 |
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 $1,023.29 Median $1,230.27 Typical High $1,862.09 | Professional | None | $1,023.29 | $1,230.27 | $1,862.09 |
United Setting Facility Modifier None Typical Low $1,380.38 Median $4,365.16 Typical High $9,772.37 | Facility | None | $1,380.38 | $4,365.16 | $9,772.37 |
United Setting Professional Modifier None Typical Low $524.81 Median $794.33 Typical High $1,445.44 | Professional | None | $524.81 | $794.33 | $1,445.44 |
Wellmark Setting Professional Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $1,230.27 | Professional | None | $1,047.13 | $1,047.13 | $1,230.27 |
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 $239.88 Median $416.87 Typical High $416.87 | Professional | 52 · Reduced service | $239.88 | $416.87 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $165.96 Typical High $165.96 | Professional | 53 · Discontinued | $95.50 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $616.60 Typical High $616.60 | Professional | 54 · Surgery only | $363.08 | $616.60 | $616.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $123.03 Typical High $123.03 | Professional | 55 · Aftercare only | $72.44 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $83.18 Typical High $83.18 | Professional | 56 · Pre-op care only | $47.86 | $83.18 | $83.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $575.44 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $338.84 | $575.44 | $575.44 |
Where Iowa sits
The same service costs 4.5 times more in Connecticut 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
CT $7,632MT $1,703
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.