How much rates vary
Facilitymedian $2,042 · 10th to 90th $1,072 to $6,310Professionalmedian $1,413 · 10th to 90th $813 to $2,089
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 $1,023.29 Median $4,265.80 Typical High $7,244.36 | Facility | None | $1,023.29 | $4,265.80 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $676.08 Median $1,023.29 Typical High $1,202.26 | Professional | None | $676.08 | $1,023.29 | $1,202.26 |
Cigna Setting Facility Modifier None Typical Low $1,096.48 Median $1,548.82 Typical High $1,862.09 | Facility | None | $1,096.48 | $1,548.82 | $1,862.09 |
Cigna Setting Professional Modifier None Typical Low $1,412.54 Median $1,659.59 Typical High $1,995.26 | Professional | None | $1,412.54 | $1,659.59 | $1,995.26 |
Hally Health Setting Professional Modifier None Typical Low $676.08 Median $1,096.48 Typical High $1,819.70 | Professional | None | $676.08 | $1,096.48 | $1,819.70 |
Medica Setting Facility Modifier None Typical Low $933.25 Median $1,905.46 Typical High $5,888.44 | Facility | None | $933.25 | $1,905.46 | $5,888.44 |
Medica Setting Professional Modifier None Typical Low $831.76 Median $1,548.82 Typical High $5,370.32 | Professional | None | $831.76 | $1,548.82 | $5,370.32 |
Midlands Setting Professional Modifier None Typical Low $1,412.54 Median $1,659.59 Typical High $1,995.26 | Professional | None | $1,412.54 | $1,659.59 | $1,995.26 |
Midlands Setting Facility Modifier None Typical Low $1,096.48 Median $1,548.82 Typical High $1,862.09 | Facility | None | $1,096.48 | $1,548.82 | $1,862.09 |
Midlands Setting Professional Modifier None Typical Low $1,412.54 Median $1,621.81 Typical High $2,344.23 | Professional | None | $1,412.54 | $1,621.81 | $2,344.23 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $3,311.31 Typical High $6,456.54 | Facility | None | $1,258.93 | $3,311.31 | $6,456.54 |
United Setting Professional Modifier None Typical Low $724.44 Median $1,096.48 Typical High $2,041.74 | Professional | None | $724.44 | $1,096.48 | $2,041.74 |
Wellmark Setting Professional Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $1,584.89 | Professional | None | $1,348.96 | $1,348.96 | $1,584.89 |
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 $338.84 Median $512.86 Typical High $512.86 | Professional | 52 · Reduced service | $338.84 | $512.86 | $512.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $208.93 Typical High $208.93 | Professional | 53 · Discontinued | $134.90 | $208.93 | $208.93 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $776.25 Typical High $776.25 | Professional | 54 · Surgery only | $512.86 | $776.25 | $776.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $154.88 Typical High $154.88 | Professional | 55 · Aftercare only | $102.33 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $102.33 Typical High $102.33 | Professional | 56 · Pre-op care only | $67.61 | $102.33 | $102.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $724.44 Typical High $724.44 | Professional | 78 · Unplanned return to OR | $478.63 | $724.44 | $724.44 |
Where Iowa sits
The same service costs 3.0 times more in Alaska than in Maryland. 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
AK $5,643MD $1,856
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.