How much rates vary
Facilitymedian $5,754 · 10th to 90th $2,089 to $14,791Professionalmedian $2,399 · 10th to 90th $1,349 to $3,388
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 $1,698.24 Median $6,165.95 Typical High $9,332.54 | Facility | None | $1,698.24 | $6,165.95 | $9,332.54 |
Aetna Setting Professional Modifier None Typical Low $1,096.48 Median $1,698.24 Typical High $1,698.24 | Professional | None | $1,096.48 | $1,698.24 | $1,698.24 |
Cigna Setting Facility Modifier None Typical Low $3,715.35 Median $6,165.95 Typical High $7,762.47 | Facility | None | $3,715.35 | $6,165.95 | $7,762.47 |
Cigna Setting Professional Modifier None Typical Low $2,290.87 Median $2,818.38 Typical High $3,311.31 | Professional | None | $2,290.87 | $2,818.38 | $3,311.31 |
Hally Health Setting Professional Modifier None Typical Low $1,122.02 Median $1,737.80 Typical High $3,019.95 | Professional | None | $1,122.02 | $1,737.80 | $3,019.95 |
Medica Setting Facility Modifier None Typical Low $2,089.30 Median $4,677.35 Typical High $14,791.08 | Facility | None | $2,089.30 | $4,677.35 | $14,791.08 |
Medica Setting Professional Modifier None Typical Low $1,348.96 Median $2,511.89 Typical High $10,000.00 | Professional | None | $1,348.96 | $2,511.89 | $10,000.00 |
Midlands Setting Professional Modifier None Typical Low $2,398.83 Median $2,691.53 Typical High $3,311.31 | Professional | None | $2,398.83 | $2,691.53 | $3,311.31 |
Midlands Setting Facility Modifier None Typical Low $3,715.35 Median $6,165.95 Typical High $7,762.47 | Facility | None | $3,715.35 | $6,165.95 | $7,762.47 |
Midlands Setting Professional Modifier None Typical Low $2,398.83 Median $2,754.23 Typical High $3,801.89 | Professional | None | $2,398.83 | $2,754.23 | $3,801.89 |
Oscar Health Setting Professional Modifier None Typical Low $1,288.25 Median $2,290.87 Typical High $3,090.30 | Professional | None | $1,288.25 | $2,290.87 | $3,090.30 |
United Setting Facility Modifier None Typical Low $1,819.70 Median $6,309.57 Typical High $19,054.61 | Facility | None | $1,819.70 | $6,309.57 | $19,054.61 |
United Setting Professional Modifier None Typical Low $1,202.26 Median $1,819.70 Typical High $3,235.94 | Professional | None | $1,202.26 | $1,819.70 | $3,235.94 |
Wellmark Setting Professional Modifier None Typical Low $2,398.83 Median $2,398.83 Typical High $2,818.38 | Professional | None | $2,398.83 | $2,398.83 | $2,818.38 |
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 $549.54 Median $851.14 Typical High $851.14 | Professional | 52 · Reduced service | $549.54 | $851.14 | $851.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $218.78 Median $338.84 Typical High $338.84 | Professional | 53 · Discontinued | $218.78 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $1,258.93 Typical High $1,258.93 | Professional | 54 · Surgery only | $812.83 | $1,258.93 | $1,258.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $251.19 Typical High $251.19 | Professional | 55 · Aftercare only | $162.18 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $169.82 Typical High $169.82 | Professional | 56 · Pre-op care only | $109.65 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $1,174.90 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $758.58 | $1,174.90 | $1,174.90 |
Where Iowa sits
The same service costs 5.0 times more in Colorado than in Kentucky. 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
CO $15,188KY $3,022
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.