How much rates vary
Facilitymedian $1,660 · 10th to 90th $646 to $5,888Professionalmedian $631 · 10th to 90th $347 to $1,122
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 $549.54 Median $3,311.31 Typical High $6,760.83 | Facility | None | $549.54 | $3,311.31 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $239.88 Median $389.05 Typical High $676.08 | Professional | None | $239.88 | $389.05 | $676.08 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $1,659.59 Typical High $1,949.84 | Facility | None | $954.99 | $1,659.59 | $1,949.84 |
Cigna Setting Professional Modifier None Typical Low $524.81 Median $741.31 Typical High $912.01 | Professional | None | $524.81 | $741.31 | $912.01 |
Hally Health Setting Professional Modifier None Typical Low $213.80 Median $467.74 Typical High $1,202.26 | Professional | None | $213.80 | $467.74 | $1,202.26 |
Medica Setting Facility Modifier None Typical Low $616.60 Median $1,071.52 Typical High $5,495.41 | Facility | None | $616.60 | $1,071.52 | $5,495.41 |
Medica Setting Professional Modifier None Typical Low $512.86 Median $758.58 Typical High $1,949.84 | Professional | None | $512.86 | $758.58 | $1,949.84 |
Midlands Setting Professional Modifier None Typical Low $524.81 Median $741.31 Typical High $912.01 | Professional | None | $524.81 | $741.31 | $912.01 |
Midlands Setting Facility Modifier None Typical Low $977.24 Median $1,659.59 Typical High $1,949.84 | Facility | None | $977.24 | $1,659.59 | $1,949.84 |
Midlands Setting Professional Modifier None Typical Low $436.52 Median $691.83 Typical High $1,047.13 | Professional | None | $436.52 | $691.83 | $1,047.13 |
Oscar Health Setting Facility Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $1,148.15 | Facility | None | $1,148.15 | $1,148.15 | $1,148.15 |
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 $263.03 Median $549.54 Typical High $1,023.29 | Professional | None | $263.03 | $549.54 | $1,023.29 |
Wellmark Setting Professional Modifier None Typical Low $436.52 Median $512.86 Typical High $812.83 | Professional | None | $436.52 | $512.86 | $812.83 |
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 $131.83 Median $194.98 Typical High $275.42 | Professional | 52 · Reduced service | $131.83 | $194.98 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $52.48 Median $77.62 Typical High $109.65 | Professional | 53 · Discontinued | $52.48 | $77.62 | $109.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $194.98 Median $288.40 Typical High $416.87 | Professional | 54 · Surgery only | $194.98 | $288.40 | $416.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $39.81 Median $57.54 Typical High $83.18 | Professional | 55 · Aftercare only | $39.81 | $57.54 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $38.90 Typical High $54.95 | Professional | 56 · Pre-op care only | $26.30 | $38.90 | $54.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $181.97 Median $269.15 Typical High $389.05 | Professional | 78 · Unplanned return to OR | $181.97 | $269.15 | $389.05 |
Where Iowa sits
The same service costs 4.6 times more in Alaska than in Utah. 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.
Iowa· 5th of 51
$724
AK $1,259UT $275
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.