How much rates vary
Facilitymedian $8,511 · 10th to 90th $1,259 to $17,783Professionalmedian $6,457 · 10th to 90th $676 to $14,454
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 $676.08 Median $4,897.79 Typical High $7,244.36 | Facility | None | $676.08 | $4,897.79 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $426.58 Median $4,168.69 Typical High $6,918.31 | Professional | None | $426.58 | $4,168.69 | $6,918.31 |
Cigna Setting Facility Modifier None Typical Low $7,762.47 Median $11,220.18 Typical High $14,454.40 | Facility | None | $7,762.47 | $11,220.18 | $14,454.40 |
Cigna Setting Professional Modifier None Typical Low $933.25 Median $8,912.51 Typical High $13,182.57 | Professional | None | $933.25 | $8,912.51 | $13,182.57 |
Hally Health Setting Professional Modifier None Typical Low $389.05 Median $724.44 Typical High $7,079.46 | Professional | None | $389.05 | $724.44 | $7,079.46 |
Medica Setting Facility Modifier None Typical Low $1,122.02 Median $8,511.38 Typical High $17,782.79 | Facility | None | $1,122.02 | $8,511.38 | $17,782.79 |
Medica Setting Professional Modifier None Typical Low $1,122.02 Median $10,471.29 Typical High $16,982.44 | Professional | None | $1,122.02 | $10,471.29 | $16,982.44 |
Midlands Setting Professional Modifier None Typical Low $933.25 Median $9,772.37 Typical High $12,882.50 | Professional | None | $933.25 | $9,772.37 | $12,882.50 |
Midlands Setting Facility Modifier None Typical Low $6,760.83 Median $11,220.18 Typical High $14,454.40 | Facility | None | $6,760.83 | $11,220.18 | $14,454.40 |
Midlands Setting Professional Modifier None Typical Low $1,412.54 Median $1,412.54 Typical High $14,791.08 | Professional | None | $1,412.54 | $1,412.54 | $14,791.08 |
United Setting Facility Modifier None Typical Low $2,630.27 Median $10,232.93 Typical High $30,199.52 | Facility | None | $2,630.27 | $10,232.93 | $30,199.52 |
United Setting Professional Modifier None Typical Low $512.86 Median $4,786.30 Typical High $14,125.38 | Professional | None | $512.86 | $4,786.30 | $14,125.38 |
Wellmark Setting Professional Modifier None Typical Low $776.25 Median $912.01 Typical High $10,715.19 | Professional | None | $776.25 | $912.01 | $10,715.19 |
5 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 $257.04 Median $338.84 Typical High $3,467.37 | Professional | 52 · Reduced service | $257.04 | $338.84 | $3,467.37 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $134.90 Typical High $1,412.54 | Professional | 53 · Discontinued | $102.33 | $134.90 | $1,412.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $407.38 Median $512.86 Typical High $5,248.07 | Professional | 54 · Surgery only | $407.38 | $512.86 | $5,248.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $102.33 Typical High $1,047.13 | Professional | 55 · Aftercare only | $77.62 | $102.33 | $1,047.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $67.61 Typical High $691.83 | Professional | 56 · Pre-op care only | $51.29 | $67.61 | $691.83 |
Where Iowa sits
The same service costs 4.3 times more in Alabama than in Maine. 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
AL $20,420ME $4,758
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.