How much rates vary
Facilitymedian $2,344 · 10th to 90th $1,288 to $6,918Professionalmedian $1,479 · 10th to 90th $851 to $2,188
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 $1,318.26 Median $5,370.32 Typical High $7,943.28 | Facility | None | $1,318.26 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $812.83 Median $1,318.26 Typical High $1,318.26 | Professional | None | $812.83 | $1,318.26 | $1,318.26 |
Cigna Setting Facility Modifier None Typical Low $1,584.89 Median $2,089.30 Typical High $2,454.71 | Facility | None | $1,584.89 | $2,089.30 | $2,454.71 |
Cigna Setting Professional Modifier None Typical Low $851.14 Median $1,659.59 Typical High $2,089.30 | Professional | None | $851.14 | $1,659.59 | $2,089.30 |
Hally Health Setting Professional Modifier None Typical Low $630.96 Median $912.01 Typical High $1,348.96 | Professional | None | $630.96 | $912.01 | $1,348.96 |
Medica Setting Facility Modifier None Typical Low $1,148.15 Median $1,995.26 Typical High $6,918.31 | Facility | None | $1,148.15 | $1,995.26 | $6,918.31 |
Medica Setting Professional Modifier None Typical Low $933.25 Median $1,659.59 Typical High $5,623.41 | Professional | None | $933.25 | $1,659.59 | $5,623.41 |
Midlands Setting Professional Modifier None Typical Low $1,659.59 Median $1,659.59 Typical High $1,949.84 | Professional | None | $1,659.59 | $1,659.59 | $1,949.84 |
Midlands Setting Facility Modifier None Typical Low $1,584.89 Median $2,041.74 Typical High $2,454.71 | Facility | None | $1,584.89 | $2,041.74 | $2,454.71 |
Midlands Setting Professional Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $1,479.11 | Professional | None | $1,479.11 | $1,479.11 | $1,479.11 |
Oscar Health Setting Professional Modifier None Typical Low $1,023.29 Median $1,174.90 Typical High $1,380.38 | Professional | None | $1,023.29 | $1,174.90 | $1,380.38 |
United Setting Facility Modifier None Typical Low $1,412.54 Median $3,467.37 Typical High $7,079.46 | Facility | None | $1,412.54 | $3,467.37 | $7,079.46 |
United Setting Professional Modifier None Typical Low $831.76 Median $1,258.93 Typical High $2,290.87 | Professional | None | $831.76 | $1,258.93 | $2,290.87 |
Wellmark Setting Professional Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $1,737.80 | Professional | None | $1,479.11 | $1,479.11 | $1,737.80 |
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 $398.11 Median $660.69 Typical High $660.69 | Professional | 52 · Reduced service | $398.11 | $660.69 | $660.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $263.03 Typical High $263.03 | Professional | 53 · Discontinued | $162.18 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $602.56 Median $977.24 Typical High $977.24 | Professional | 54 · Surgery only | $602.56 | $977.24 | $977.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $199.53 Typical High $199.53 | Professional | 55 · Aftercare only | $120.23 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $131.83 Typical High $131.83 | Professional | 56 · Pre-op care only | $81.28 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $562.34 Median $912.01 Typical High $912.01 | Professional | 78 · Unplanned return to OR | $562.34 | $912.01 | $912.01 |
Where Iowa sits
The same service costs 4.6 times more in Alaska than in New York. 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.
Iowa· 5th of 51
$1,660
AK $3,090NY $676
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.