How much rates vary
Facilitymedian $2,455 · 10th to 90th $1,072 to $6,607Professionalmedian $1,549 · 10th to 90th $851 to $2,399
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 $1,380.38 Median $4,265.80 Typical High $7,244.36 | Facility | None | $1,380.38 | $4,265.80 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $794.33 Median $1,380.38 Typical High $1,380.38 | Professional | None | $794.33 | $1,380.38 | $1,380.38 |
Cigna Setting Facility Modifier None Typical Low $1,584.89 Median $2,137.96 Typical High $2,630.27 | Facility | None | $1,584.89 | $2,137.96 | $2,630.27 |
Cigna Setting Professional Modifier None Typical Low $933.25 Median $1,698.24 Typical High $2,344.23 | Professional | None | $933.25 | $1,698.24 | $2,344.23 |
Hally Health Setting Professional Modifier None Typical Low $575.44 Median $954.99 Typical High $2,187.76 | Professional | None | $575.44 | $954.99 | $2,187.76 |
Medica Setting Facility Modifier None Typical Low $954.99 Median $2,137.96 Typical High $6,606.93 | Facility | None | $954.99 | $2,137.96 | $6,606.93 |
Medica Setting Professional Modifier None Typical Low $954.99 Median $1,819.70 Typical High $5,888.44 | Professional | None | $954.99 | $1,819.70 | $5,888.44 |
Midlands Setting Professional Modifier None Typical Low $1,698.24 Median $1,698.24 Typical High $2,137.96 | Professional | None | $1,698.24 | $1,698.24 | $2,137.96 |
Midlands Setting Facility Modifier None Typical Low $1,479.11 Median $2,089.30 Typical High $2,630.27 | Facility | None | $1,479.11 | $2,089.30 | $2,630.27 |
Midlands Setting Professional Modifier None Typical Low $1,548.82 Median $1,548.82 Typical High $1,548.82 | Professional | None | $1,548.82 | $1,548.82 | $1,548.82 |
Oscar Health Setting Professional Modifier None Typical Low $691.83 Median $1,258.93 Typical High $1,513.56 | Professional | None | $691.83 | $1,258.93 | $1,513.56 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $3,467.37 Typical High $7,079.46 | Facility | None | $1,258.93 | $3,467.37 | $7,079.46 |
United Setting Professional Modifier None Typical Low $851.14 Median $1,288.25 Typical High $2,238.72 | Professional | None | $851.14 | $1,288.25 | $2,238.72 |
Wellmark Setting Professional Modifier None Typical Low $1,445.44 Median $1,445.44 Typical High $1,698.24 | Professional | None | $1,445.44 | $1,445.44 | $1,698.24 |
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 $407.38 Median $691.83 Typical High $691.83 | Professional | 52 · Reduced service | $407.38 | $691.83 | $691.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $275.42 Typical High $275.42 | Professional | 53 · Discontinued | $165.96 | $275.42 | $275.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $1,047.13 Typical High $1,047.13 | Professional | 54 · Surgery only | $616.60 | $1,047.13 | $1,047.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $208.93 Typical High $208.93 | Professional | 55 · Aftercare only | $123.03 | $208.93 | $208.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $138.04 Typical High $138.04 | Professional | 56 · Pre-op care only | $81.28 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $977.24 Typical High $977.24 | Professional | 78 · Unplanned return to OR | $575.44 | $977.24 | $977.24 |
Where Iowa sits
The same service costs 3.7 times more in Oklahoma than in Mississippi. 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
OK $7,181MS $1,948
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.