How much rates vary
Facilitymedian $1,905 · 10th to 90th $977 to $6,457Professionalmedian $1,023 · 10th to 90th $589 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 $794.33 Median $4,168.69 Typical High $7,244.36 | Facility | None | $794.33 | $4,168.69 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $467.74 Median $794.33 Typical High $1,071.52 | Professional | None | $467.74 | $794.33 | $1,071.52 |
Cigna Setting Facility Modifier None Typical Low $1,096.48 Median $1,737.80 Typical High $2,137.96 | Facility | None | $1,096.48 | $1,737.80 | $2,137.96 |
Cigna Setting Professional Modifier None Typical Low $549.54 Median $1,148.15 Typical High $1,584.89 | Professional | None | $549.54 | $1,148.15 | $1,584.89 |
Hally Health Setting Professional Modifier None Typical Low $407.38 Median $741.31 Typical High $1,047.13 | Professional | None | $407.38 | $741.31 | $1,047.13 |
Medica Setting Facility Modifier None Typical Low $977.24 Median $1,584.89 Typical High $6,025.60 | Facility | None | $977.24 | $1,584.89 | $6,025.60 |
Medica Setting Professional Modifier None Typical Low $741.31 Median $1,202.26 Typical High $4,365.16 | Professional | None | $741.31 | $1,202.26 | $4,365.16 |
Midlands Setting Professional Modifier None Typical Low $1,023.29 Median $1,230.27 Typical High $1,479.11 | Professional | None | $1,023.29 | $1,230.27 | $1,479.11 |
Midlands Setting Facility Modifier None Typical Low $1,096.48 Median $1,698.24 Typical High $2,137.96 | Facility | None | $1,096.48 | $1,698.24 | $2,137.96 |
Midlands Setting Professional Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $1,122.02 | Professional | None | $1,122.02 | $1,122.02 | $1,122.02 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $3,548.13 Typical High $7,413.10 | Facility | None | $1,258.93 | $3,548.13 | $7,413.10 |
United Setting Professional Modifier None Typical Low $524.81 Median $891.25 Typical High $1,548.82 | Professional | None | $524.81 | $891.25 | $1,548.82 |
Wellmark Setting Professional Modifier None Typical Low $812.83 Median $954.99 Typical High $1,445.44 | Professional | None | $812.83 | $954.99 | $1,445.44 |
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 $275.42 Median $398.11 Typical High $512.86 | Professional | 52 · Reduced service | $275.42 | $398.11 | $512.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $158.49 Typical High $204.17 | Professional | 53 · Discontinued | $109.65 | $158.49 | $204.17 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $407.38 Median $602.56 Typical High $776.25 | Professional | 54 · Surgery only | $407.38 | $602.56 | $776.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $120.23 Typical High $154.88 | Professional | 55 · Aftercare only | $81.28 | $120.23 | $154.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $79.43 Typical High $102.33 | Professional | 56 · Pre-op care only | $54.95 | $79.43 | $102.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $380.19 Median $562.34 Typical High $724.44 | Professional | 78 · Unplanned return to OR | $380.19 | $562.34 | $724.44 |
Where Iowa sits
The same service costs 4.0 times more in Oklahoma than in West Virginia. 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 $5,056WV $1,262
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.