How much rates vary
Facilitymedian $1,230 · 10th to 90th $479 to $4,677Professionalmedian $1,072 · 10th to 90th $550 to $1,514
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 $870.96 Median $5,248.07 Typical High $7,943.28 | Facility | None | $870.96 | $5,248.07 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $512.86 Median $870.96 Typical High $933.25 | Professional | None | $512.86 | $870.96 | $933.25 |
Cigna Setting Facility Modifier None Typical Low $380.19 Median $489.78 Typical High $616.60 | Facility | None | $380.19 | $489.78 | $616.60 |
Cigna Setting Professional Modifier None Typical Low $602.56 Median $1,148.15 Typical High $1,445.44 | Professional | None | $602.56 | $1,148.15 | $1,445.44 |
Hally Health Setting Professional Modifier None Typical Low $446.68 Median $676.08 Typical High $1,122.02 | Professional | None | $446.68 | $676.08 | $1,122.02 |
Medica Setting Facility Modifier None Typical Low $501.19 Median $1,288.25 Typical High $3,235.94 | Facility | None | $501.19 | $1,288.25 | $3,235.94 |
Medica Setting Professional Modifier None Typical Low $776.25 Median $1,202.26 Typical High $3,801.89 | Professional | None | $776.25 | $1,202.26 | $3,801.89 |
Midlands Setting Professional Modifier None Typical Low $1,096.48 Median $1,148.15 Typical High $1,348.96 | Professional | None | $1,096.48 | $1,148.15 | $1,348.96 |
Midlands Setting Facility Modifier None Typical Low $380.19 Median $478.63 Typical High $616.60 | Facility | None | $380.19 | $478.63 | $616.60 |
Midlands Setting Professional Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $1,023.29 | Professional | None | $1,023.29 | $1,023.29 | $1,023.29 |
Oscar Health Setting Professional Modifier None Typical Low $457.09 Median $831.76 Typical High $1,096.48 | Professional | None | $457.09 | $831.76 | $1,096.48 |
United Setting Facility Modifier None Typical Low $501.19 Median $1,479.11 Typical High $4,073.80 | Facility | None | $501.19 | $1,479.11 | $4,073.80 |
United Setting Professional Modifier None Typical Low $549.54 Median $870.96 Typical High $1,479.11 | Professional | None | $549.54 | $870.96 | $1,479.11 |
Wellmark Setting Professional Modifier None Typical Low $891.25 Median $1,047.13 Typical High $1,258.93 | Professional | None | $891.25 | $1,047.13 | $1,258.93 |
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 $263.03 Median $436.52 Typical High $446.68 | Professional | 52 · Reduced service | $263.03 | $436.52 | $446.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $173.78 Typical High $181.97 | Professional | 53 · Discontinued | $104.71 | $173.78 | $181.97 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $398.11 Median $660.69 Typical High $676.08 | Professional | 54 · Surgery only | $398.11 | $660.69 | $676.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $131.83 Typical High $134.90 | Professional | 55 · Aftercare only | $79.43 | $131.83 | $134.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $87.10 Typical High $89.13 | Professional | 56 · Pre-op care only | $52.48 | $87.10 | $89.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $371.54 Median $616.60 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $371.54 | $616.60 | $630.96 |
Where Iowa sits
The same service costs 6.2 times more in Alaska than in Utah. 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· 4th of 51
$1,072
AK $1,995UT $324
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.