How much rates vary
Facilitymedian $3,090 · 10th to 90th $891 to $8,710Professionalmedian $955 · 10th to 90th $513 to $1,288
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 $724.44 Median $4,265.80 Typical High $7,244.36 | Facility | None | $724.44 | $4,265.80 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $426.58 Median $724.44 Typical High $724.44 | Professional | None | $426.58 | $724.44 | $724.44 |
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 $870.96 Median $1,047.13 Typical High $1,258.93 | Professional | None | $870.96 | $1,047.13 | $1,258.93 |
Hally Health Setting Professional Modifier None Typical Low $426.58 Median $691.83 Typical High $1,202.26 | Professional | None | $426.58 | $691.83 | $1,202.26 |
Medica Setting Facility Modifier None Typical Low $776.25 Median $2,344.23 Typical High $8,912.51 | Facility | None | $776.25 | $2,344.23 | $8,912.51 |
Medica Setting Professional Modifier None Typical Low $512.86 Median $1,023.29 Typical High $3,388.44 | Professional | None | $512.86 | $1,023.29 | $3,388.44 |
Midlands Setting Professional Modifier None Typical Low $891.25 Median $1,023.29 Typical High $1,230.27 | Professional | None | $891.25 | $1,023.29 | $1,230.27 |
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 $870.96 Median $1,071.52 Typical High $1,548.82 | Professional | None | $870.96 | $1,071.52 | $1,548.82 |
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 $446.68 Median $676.08 Typical High $1,258.93 | Professional | None | $446.68 | $676.08 | $1,258.93 |
Wellmark Setting Professional Modifier None Typical Low $912.01 Median $912.01 Typical High $1,071.52 | Professional | None | $912.01 | $912.01 | $1,071.52 |
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 $208.93 Median $363.08 Typical High $363.08 | Professional | 52 · Reduced service | $208.93 | $363.08 | $363.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $85.11 Median $144.54 Typical High $144.54 | Professional | 53 · Discontinued | $85.11 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $549.54 Typical High $549.54 | Professional | 54 · Surgery only | $316.23 | $549.54 | $549.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $109.65 Typical High $109.65 | Professional | 55 · Aftercare only | $63.10 | $109.65 | $109.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $42.66 Median $72.44 Typical High $72.44 | Professional | 56 · Pre-op care only | $42.66 | $72.44 | $72.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $295.12 Median $512.86 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $295.12 | $512.86 | $512.86 |
Where Iowa sits
The same service costs 4.9 times more in Wisconsin 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
WI $7,341MT $1,483
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.