How much rates vary
Facilitymedian $2,291 · 10th to 90th $851 to $6,761Professionalmedian $1,023 · 10th to 90th $550 to $1,622
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 $977.24 Median $2,951.21 Typical High $6,760.83 | Facility | None | $977.24 | $2,951.21 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $575.44 Median $977.24 Typical High $977.24 | Professional | None | $575.44 | $977.24 | $977.24 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $2,089.30 Typical High $2,454.71 | Facility | None | $645.65 | $2,089.30 | $2,454.71 |
Cigna Setting Professional Modifier None Typical Low $616.60 Median $1,230.27 Typical High $1,621.81 | Professional | None | $616.60 | $1,230.27 | $1,621.81 |
Hally Health Setting Professional Modifier None Typical Low $489.78 Median $660.69 Typical High $1,122.02 | Professional | None | $489.78 | $660.69 | $1,122.02 |
Medica Setting Facility Modifier None Typical Low $831.76 Median $1,659.59 Typical High $6,918.31 | Facility | None | $831.76 | $1,659.59 | $6,918.31 |
Medica Setting Professional Modifier None Typical Low $616.60 Median $1,202.26 Typical High $4,168.69 | Professional | None | $616.60 | $1,202.26 | $4,168.69 |
Midlands Setting Professional Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $1,513.56 | Professional | None | $1,230.27 | $1,230.27 | $1,513.56 |
Midlands Setting Facility Modifier None Typical Low $1,288.25 Median $2,041.74 Typical High $2,454.71 | Facility | None | $1,288.25 | $2,041.74 | $2,454.71 |
Midlands Setting Professional Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $1,047.13 | Professional | None | $1,047.13 | $1,047.13 | $1,047.13 |
Oscar Health Setting Professional Modifier None Typical Low $489.78 Median $891.25 Typical High $1,096.48 | Professional | None | $489.78 | $891.25 | $1,096.48 |
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 $562.34 Median $831.76 Typical High $1,548.82 | Professional | None | $562.34 | $831.76 | $1,548.82 |
Wellmark Setting Professional Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $1,202.26 | Professional | None | $1,023.29 | $1,023.29 | $1,202.26 |
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 $288.40 Median $489.78 Typical High $489.78 | Professional | 52 · Reduced service | $288.40 | $489.78 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $114.82 Median $194.98 Typical High $194.98 | Professional | 53 · Discontinued | $114.82 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $436.52 Median $724.44 Typical High $724.44 | Professional | 54 · Surgery only | $436.52 | $724.44 | $724.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $87.10 Median $144.54 Typical High $144.54 | Professional | 55 · Aftercare only | $87.10 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $97.72 Typical High $97.72 | Professional | 56 · Pre-op care only | $57.54 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $407.38 Median $676.08 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $407.38 | $676.08 | $676.08 |
Where Iowa sits
The same service costs 8.3 times more in Wyoming than in Texas. 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
$1,202
WY $2,512TX $302
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.