How much rates vary
Facilitymedian $1,820 · 10th to 90th $525 to $6,166Professionalmedian $525 · 10th to 90th $309 to $977
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 $489.78 Median $3,388.44 Typical High $6,760.83 | Facility | None | $489.78 | $3,388.44 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $218.78 Median $309.03 Typical High $489.78 | Professional | None | $218.78 | $309.03 | $489.78 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $1,698.24 Typical High $1,995.26 | Facility | None | $954.99 | $1,698.24 | $1,995.26 |
Cigna Setting Professional Modifier None Typical Low $389.05 Median $630.96 Typical High $977.24 | Professional | None | $389.05 | $630.96 | $977.24 |
Hally Health Setting Professional Modifier None Typical Low $186.21 Median $467.74 Typical High $660.69 | Professional | None | $186.21 | $467.74 | $660.69 |
Medica Setting Facility Modifier None Typical Low $457.09 Median $954.99 Typical High $5,495.41 | Facility | None | $457.09 | $954.99 | $5,495.41 |
Medica Setting Professional Modifier None Typical Low $380.19 Median $691.83 Typical High $1,479.11 | Professional | None | $380.19 | $691.83 | $1,479.11 |
Midlands Setting Professional Modifier None Typical Low $389.05 Median $691.83 Typical High $977.24 | Professional | None | $389.05 | $691.83 | $977.24 |
Midlands Setting Facility Modifier None Typical Low $977.24 Median $1,737.80 Typical High $2,089.30 | Facility | None | $977.24 | $1,737.80 | $2,089.30 |
Midlands Setting Professional Modifier None Typical Low $380.19 Median $537.03 Typical High $1,122.02 | Professional | None | $380.19 | $537.03 | $1,122.02 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $3,388.44 Typical High $6,606.93 | Facility | None | $1,258.93 | $3,388.44 | $6,606.93 |
United Setting Professional Modifier None Typical Low $234.42 Median $467.74 Typical High $831.76 | Professional | None | $234.42 | $467.74 | $831.76 |
Wellmark Setting Professional Modifier None Typical Low $354.81 Median $416.87 Typical High $776.25 | Professional | None | $354.81 | $416.87 | $776.25 |
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 $104.71 Median $154.88 Typical High $245.47 | Professional | 52 · Reduced service | $104.71 | $154.88 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $61.66 Typical High $97.72 | Professional | 53 · Discontinued | $41.69 | $61.66 | $97.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $154.88 Median $234.42 Typical High $371.54 | Professional | 54 · Surgery only | $154.88 | $234.42 | $371.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $46.77 Typical High $74.13 | Professional | 55 · Aftercare only | $30.90 | $46.77 | $74.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $30.90 Typical High $48.98 | Professional | 56 · Pre-op care only | $20.89 | $30.90 | $48.98 |
Where Iowa sits
The same service costs 7.9 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 $5,867MT $745
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.