How much rates vary
Facilitymedian $5,754 · 10th to 90th $617 to $22,387Professionalmedian $1,549 · 10th to 90th $380 to $11,220
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 $616.60 Median $3,388.44 Typical High $6,760.83 | Facility | None | $616.60 | $3,388.44 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $398.11 Median $616.60 Typical High $5,128.61 | Professional | None | $398.11 | $616.60 | $5,128.61 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $13,803.84 Typical High $20,417.38 | Facility | None | $645.65 | $13,803.84 | $20,417.38 |
Cigna Setting Professional Modifier None Typical Low $794.33 Median $1,445.44 Typical High $8,511.38 | Professional | None | $794.33 | $1,445.44 | $8,511.38 |
Hally Health Setting Professional Modifier None Typical Low $323.59 Median $426.58 Typical High $4,897.79 | Professional | None | $323.59 | $426.58 | $4,897.79 |
Medica Setting Facility Modifier None Typical Low $446.68 Median $5,128.61 Typical High $22,908.68 | Facility | None | $446.68 | $5,128.61 | $22,908.68 |
Medica Setting Professional Modifier None Typical Low $380.19 Median $2,818.38 Typical High $28,183.83 | Professional | None | $380.19 | $2,818.38 | $28,183.83 |
Midlands Setting Professional Modifier None Typical Low $676.08 Median $3,890.45 Typical High $8,511.38 | Professional | None | $676.08 | $3,890.45 | $8,511.38 |
Midlands Setting Facility Modifier None Typical Low $6,309.57 Median $14,125.38 Typical High $19,498.45 | Facility | None | $6,309.57 | $14,125.38 | $19,498.45 |
Midlands Setting Professional Modifier None Typical Low $323.59 Median $707.95 Typical High $6,918.31 | Professional | None | $323.59 | $707.95 | $6,918.31 |
United Setting Facility Modifier None Typical Low $1,819.70 Median $6,309.57 Typical High $29,512.09 | Facility | None | $1,819.70 | $6,309.57 | $29,512.09 |
United Setting Professional Modifier None Typical Low $245.47 Median $831.76 Typical High $4,677.35 | Professional | None | $245.47 | $831.76 | $4,677.35 |
Wellmark Setting Professional Modifier None Typical Low $891.25 Median $1,071.52 Typical High $11,481.54 | Professional | None | $891.25 | $1,071.52 | $11,481.54 |
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 $199.53 Median $309.03 Typical High $2,570.40 | Professional | 52 · Reduced service | $199.53 | $309.03 | $2,570.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $123.03 Typical High $1,047.13 | Professional | 53 · Discontinued | $79.43 | $123.03 | $1,047.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $295.12 Median $457.09 Typical High $3,890.45 | Professional | 54 · Surgery only | $295.12 | $457.09 | $3,890.45 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $91.20 Typical High $776.25 | Professional | 55 · Aftercare only | $58.88 | $91.20 | $776.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $61.66 Typical High $512.86 | Professional | 56 · Pre-op care only | $39.81 | $61.66 | $512.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $275.42 Median $426.58 Typical High $3,630.78 | Professional | 78 · Unplanned return to OR | $275.42 | $426.58 | $3,630.78 |
Where Iowa sits
The same service costs 18.4 times more in Alabama 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
AL $30,876MT $1,679
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.