How much rates vary
Facilitymedian $5,623 · 10th to 90th $2,291 to $15,136Professionalmedian $2,512 · 10th to 90th $1,380 to $3,548
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 $1,778.28 Median $5,370.32 Typical High $7,943.28 | Facility | None | $1,778.28 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,174.90 Median $1,778.28 Typical High $3,090.30 | Professional | None | $1,174.90 | $1,778.28 | $3,090.30 |
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 $2,454.71 Median $2,951.21 Typical High $3,548.13 | Professional | None | $2,454.71 | $2,951.21 | $3,548.13 |
Hally Health Setting Professional Modifier None Typical Low $1,202.26 Median $1,995.26 Typical High $3,388.44 | Professional | None | $1,202.26 | $1,995.26 | $3,388.44 |
Medica Setting Facility Modifier None Typical Low $2,290.87 Median $4,677.35 Typical High $17,378.01 | Facility | None | $2,290.87 | $4,677.35 | $17,378.01 |
Medica Setting Professional Modifier None Typical Low $1,445.44 Median $2,884.03 Typical High $10,471.29 | Professional | None | $1,445.44 | $2,884.03 | $10,471.29 |
Midlands Setting Professional Modifier None Typical Low $2,511.89 Median $2,884.03 Typical High $3,548.13 | Professional | None | $2,511.89 | $2,884.03 | $3,548.13 |
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 $2,511.89 Median $2,884.03 Typical High $4,365.16 | Professional | None | $2,511.89 | $2,884.03 | $4,365.16 |
Oscar Health Setting Professional Modifier None Typical Low $1,288.25 Median $2,398.83 Typical High $3,090.30 | Professional | None | $1,288.25 | $2,398.83 | $3,090.30 |
United Setting Facility Modifier None Typical Low $2,398.83 Median $6,606.93 Typical High $19,054.61 | Facility | None | $2,398.83 | $6,606.93 | $19,054.61 |
United Setting Professional Modifier None Typical Low $1,288.25 Median $1,905.46 Typical High $3,467.37 | Professional | None | $1,288.25 | $1,905.46 | $3,467.37 |
Wellmark Setting Professional Modifier None Typical Low $2,454.71 Median $2,454.71 Typical High $2,884.03 | Professional | None | $2,454.71 | $2,454.71 | $2,884.03 |
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 $588.84 Median $891.25 Typical High $891.25 | Professional | 52 · Reduced service | $588.84 | $891.25 | $891.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $363.08 Typical High $363.08 | Professional | 53 · Discontinued | $234.42 | $363.08 | $363.08 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $1,348.96 Typical High $1,348.96 | Professional | 54 · Surgery only | $870.96 | $1,348.96 | $1,348.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $269.15 Typical High $269.15 | Professional | 55 · Aftercare only | $173.78 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $177.83 Typical High $177.83 | Professional | 56 · Pre-op care only | $117.49 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $1,258.93 Typical High $1,258.93 | Professional | 78 · Unplanned return to OR | $812.83 | $1,258.93 | $1,258.93 |
Where Iowa sits
The same service costs 4.7 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 $15,002KY $3,224
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.