How much rates vary
Facilitymedian $3,162 · 10th to 90th $1,072 to $9,333Professionalmedian $1,259 · 10th to 90th $646 to $1,820
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 $977.24 Median $5,011.87 Typical High $7,244.36 | Facility | None | $977.24 | $5,011.87 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $549.54 Median $977.24 Typical High $977.24 | Professional | None | $549.54 | $977.24 | $977.24 |
Cigna Setting Facility Modifier None Typical Low $1,288.25 Median $2,818.38 Typical High $3,388.44 | Facility | None | $1,288.25 | $2,818.38 | $3,388.44 |
Cigna Setting Professional Modifier None Typical Low $630.96 Median $1,348.96 Typical High $1,621.81 | Professional | None | $630.96 | $1,348.96 | $1,621.81 |
Hally Health Setting Professional Modifier None Typical Low $549.54 Median $831.76 Typical High $1,479.11 | Professional | None | $549.54 | $831.76 | $1,479.11 |
Medica Setting Facility Modifier None Typical Low $891.25 Median $2,344.23 Typical High $9,549.93 | Facility | None | $891.25 | $2,344.23 | $9,549.93 |
Medica Setting Professional Modifier None Typical Low $676.08 Median $1,318.26 Typical High $4,365.16 | Professional | None | $676.08 | $1,318.26 | $4,365.16 |
Midlands Setting Professional Modifier None Typical Low $1,318.26 Median $1,348.96 Typical High $1,621.81 | Professional | None | $1,318.26 | $1,348.96 | $1,621.81 |
Midlands Setting Facility Modifier None Typical Low $1,737.80 Median $2,818.38 Typical High $3,388.44 | Facility | None | $1,737.80 | $2,818.38 | $3,388.44 |
Midlands Setting Professional Modifier None Typical Low $1,096.48 Median $1,479.11 Typical High $1,819.70 | Professional | None | $1,096.48 | $1,479.11 | $1,819.70 |
United Setting Facility Modifier None Typical Low $1,380.38 Median $4,365.16 Typical High $10,000.00 | Facility | None | $1,380.38 | $4,365.16 | $10,000.00 |
United Setting Professional Modifier None Typical Low $616.60 Median $831.76 Typical High $1,584.89 | Professional | None | $616.60 | $831.76 | $1,584.89 |
Wellmark Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,380.38 | Professional | None | $1,258.93 | $1,258.93 | $1,380.38 |
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 $269.15 Median $489.78 Typical High $489.78 | Professional | 52 · Reduced service | $269.15 | $489.78 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $199.53 Typical High $199.53 | Professional | 53 · Discontinued | $107.15 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $398.11 Median $741.31 Typical High $741.31 | Professional | 54 · Surgery only | $398.11 | $741.31 | $741.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $147.91 Typical High $147.91 | Professional | 55 · Aftercare only | $81.28 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $97.72 Typical High $97.72 | Professional | 56 · Pre-op care only | $53.70 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $371.54 Median $691.83 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $371.54 | $691.83 | $691.83 |
Where Iowa sits
The same service costs 4.0 times more in Oklahoma 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
OK $7,771MT $1,932
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.