How much rates vary
Facilitymedian $3,631 · 10th to 90th $891 to $11,482Professionalmedian $1,023 · 10th to 90th $537 to $1,549
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 $794.33 Median $3,981.07 Typical High $7,244.36 | Facility | None | $794.33 | $3,981.07 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $446.68 Median $794.33 Typical High $794.33 | Professional | None | $446.68 | $794.33 | $794.33 |
Cigna Setting Facility Modifier None Typical Low $3,388.44 Median $6,025.60 Typical High $8,709.64 | Facility | None | $3,388.44 | $6,025.60 | $8,709.64 |
Cigna Setting Professional Modifier None Typical Low $537.03 Median $1,047.13 Typical High $1,288.25 | Professional | None | $537.03 | $1,047.13 | $1,288.25 |
Hally Health Setting Professional Modifier None Typical Low $436.52 Median $616.60 Typical High $1,659.59 | Professional | None | $436.52 | $616.60 | $1,659.59 |
Medica Setting Facility Modifier None Typical Low $616.60 Median $1,659.59 Typical High $12,589.25 | Facility | None | $616.60 | $1,659.59 | $12,589.25 |
Medica Setting Professional Modifier None Typical Low $562.34 Median $1,023.29 Typical High $3,548.13 | Professional | None | $562.34 | $1,023.29 | $3,548.13 |
Midlands Setting Professional Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $1,288.25 | Professional | None | $1,047.13 | $1,047.13 | $1,288.25 |
Midlands Setting Facility Modifier None Typical Low $2,884.03 Median $6,025.60 Typical High $8,709.64 | Facility | None | $2,884.03 | $6,025.60 | $8,709.64 |
Midlands Setting Professional Modifier None Typical Low $851.14 Median $1,202.26 Typical High $1,479.11 | Professional | None | $851.14 | $1,202.26 | $1,479.11 |
Oscar Health Setting Professional Modifier None Typical Low $426.58 Median $794.33 Typical High $1,000.00 | Professional | None | $426.58 | $794.33 | $1,000.00 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $3,630.78 Typical High $15,848.93 | Facility | None | $1,258.93 | $3,630.78 | $15,848.93 |
United Setting Professional Modifier None Typical Low $512.86 Median $741.31 Typical High $1,348.96 | Professional | None | $512.86 | $741.31 | $1,348.96 |
Wellmark Setting Professional Modifier None Typical Low $933.25 Median $933.25 Typical High $1,023.29 | Professional | None | $933.25 | $933.25 | $1,023.29 |
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 $223.87 Median $398.11 Typical High $398.11 | Professional | 52 · Reduced service | $223.87 | $398.11 | $398.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $158.49 Typical High $158.49 | Professional | 53 · Discontinued | $89.13 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $338.84 Median $602.56 Typical High $602.56 | Professional | 54 · Surgery only | $338.84 | $602.56 | $602.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $120.23 Typical High $120.23 | Professional | 55 · Aftercare only | $67.61 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $79.43 Typical High $79.43 | Professional | 56 · Pre-op care only | $44.67 | $79.43 | $79.43 |
Where Iowa sits
The same service costs 5.9 times more in Alaska 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
AK $8,723MT $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.