How much rates vary
Facilitymedian $9,120 · 10th to 90th $1,175 to $20,417Professionalmedian $9,333 · 10th to 90th $759 to $20,893
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 $758.58 Median $7,943.28 Typical High $11,481.54 | Facility | None | $758.58 | $7,943.28 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $457.09 Median $5,128.61 Typical High $9,332.54 | Professional | None | $457.09 | $5,128.61 | $9,332.54 |
Cigna Setting Facility Modifier None Typical Low $4,265.80 Median $12,302.69 Typical High $16,218.10 | Facility | None | $4,265.80 | $12,302.69 | $16,218.10 |
Cigna Setting Professional Modifier None Typical Low $977.24 Median $5,011.87 Typical High $15,848.93 | Professional | None | $977.24 | $5,011.87 | $15,848.93 |
Hally Health Setting Professional Modifier None Typical Low $446.68 Median $6,456.54 Typical High $8,511.38 | Professional | None | $446.68 | $6,456.54 | $8,511.38 |
Medica Setting Facility Modifier None Typical Low $1,096.48 Median $9,332.54 Typical High $20,892.96 | Facility | None | $1,096.48 | $9,332.54 | $20,892.96 |
Medica Setting Professional Modifier None Typical Low $977.24 Median $13,489.63 Typical High $42,657.95 | Professional | None | $977.24 | $13,489.63 | $42,657.95 |
Midlands Setting Professional Modifier None Typical Low $1,000.00 Median $10,715.19 Typical High $14,454.40 | Professional | None | $1,000.00 | $10,715.19 | $14,454.40 |
Midlands Setting Facility Modifier None Typical Low $4,265.80 Median $12,302.69 Typical High $16,218.10 | Facility | None | $4,265.80 | $12,302.69 | $16,218.10 |
Midlands Setting Professional Modifier None Typical Low $1,202.26 Median $13,182.57 Typical High $17,782.79 | Professional | None | $1,202.26 | $13,182.57 | $17,782.79 |
Oscar Health Setting Professional Modifier None Typical Low $446.68 Median $1,023.29 Typical High $12,022.64 | Professional | None | $446.68 | $1,023.29 | $12,022.64 |
United Setting Facility Modifier None Typical Low $1,819.70 Median $6,309.57 Typical High $28,183.83 | Facility | None | $1,819.70 | $6,309.57 | $28,183.83 |
United Setting Professional Modifier None Typical Low $537.03 Median $5,128.61 Typical High $16,218.10 | Professional | None | $537.03 | $5,128.61 | $16,218.10 |
Wellmark Setting Professional Modifier None Typical Low $891.25 Median $1,023.29 Typical High $14,454.40 | Professional | None | $891.25 | $1,023.29 | $14,454.40 |
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 $229.09 Median $660.69 Typical High $4,677.35 | Professional | 52 · Reduced service | $229.09 | $660.69 | $4,677.35 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $263.03 Typical High $1,862.09 | Professional | 53 · Discontinued | $91.20 | $263.03 | $1,862.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $338.84 Median $977.24 Typical High $6,918.31 | Professional | 54 · Surgery only | $338.84 | $977.24 | $6,918.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $199.53 Typical High $1,380.38 | Professional | 55 · Aftercare only | $69.18 | $199.53 | $1,380.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $131.83 Typical High $933.25 | Professional | 56 · Pre-op care only | $45.71 | $131.83 | $933.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $316.23 Median $912.01 Typical High $6,456.54 | Professional | 78 · Unplanned return to OR | $316.23 | $912.01 | $6,456.54 |
Where Iowa sits
The same service costs 4.1 times more in Iowa than in Delaware. 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
IA $18,453DE $4,539
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.