How much rates vary
Facilitymedian $661 · 10th to 90th $275 to $3,802Professionalmedian $288 · 10th to 90th $166 to $479
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 $229.09 Median $1,288.25 Typical High $6,606.93 | Facility | None | $229.09 | $1,288.25 | $6,606.93 |
Aetna Setting Professional Modifier None Typical Low $112.20 Median $173.78 Typical High $416.87 | Professional | None | $112.20 | $173.78 | $416.87 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $645.65 Typical High $758.58 | Facility | None | $524.81 | $645.65 | $758.58 |
Cigna Setting Professional Modifier None Typical Low $251.19 Median $338.84 Typical High $436.52 | Professional | None | $251.19 | $338.84 | $436.52 |
Hally Health Setting Professional Modifier None Typical Low $107.15 Median $234.42 Typical High $436.52 | Professional | None | $107.15 | $234.42 | $436.52 |
Medica Setting Facility Modifier None Typical Low $269.15 Median $501.19 Typical High $2,290.87 | Facility | None | $269.15 | $501.19 | $2,290.87 |
Medica Setting Professional Modifier None Typical Low $208.93 Median $363.08 Typical High $1,258.93 | Professional | None | $208.93 | $363.08 | $1,258.93 |
Midlands Setting Professional Modifier None Typical Low $213.80 Median $316.23 Typical High $398.11 | Professional | None | $213.80 | $316.23 | $398.11 |
Midlands Setting Facility Modifier None Typical Low $489.78 Median $645.65 Typical High $758.58 | Facility | None | $489.78 | $645.65 | $758.58 |
Midlands Setting Professional Modifier None Typical Low $218.78 Median $338.84 Typical High $436.52 | Professional | None | $218.78 | $338.84 | $436.52 |
United Setting Facility Modifier None Typical Low $501.19 Median $1,659.59 Typical High $4,073.80 | Facility | None | $501.19 | $1,659.59 | $4,073.80 |
United Setting Professional Modifier None Typical Low $125.89 Median $218.78 Typical High $426.58 | Professional | None | $125.89 | $218.78 | $426.58 |
Wellmark Setting Professional Modifier None Typical Low $204.17 Median $269.15 Typical High $407.38 | Professional | None | $204.17 | $269.15 | $407.38 |
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 $54.95 Median $81.28 Typical High $120.23 | Professional | 52 · Reduced service | $54.95 | $81.28 | $120.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.39 Median $32.36 Typical High $47.86 | Professional | 53 · Discontinued | $22.39 | $32.36 | $47.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $83.18 Median $123.03 Typical High $177.83 | Professional | 54 · Surgery only | $83.18 | $123.03 | $177.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $24.55 Typical High $35.48 | Professional | 55 · Aftercare only | $16.60 | $24.55 | $35.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $16.22 Typical High $23.99 | Professional | 56 · Pre-op care only | $11.22 | $16.22 | $23.99 |
Where Iowa sits
The same service costs 6.3 times more in New York 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
NY $2,712MT $427
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.