How much rates vary
Facilitymedian $2,089 · 10th to 90th $1,096 to $6,457Professionalmedian $1,445 · 10th to 90th $813 to $2,239
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 $1,148.15 Median $4,168.69 Typical High $7,244.36 | Facility | None | $1,148.15 | $4,168.69 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $724.44 Median $1,148.15 Typical High $1,348.96 | Professional | None | $724.44 | $1,148.15 | $1,348.96 |
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 $776.25 Median $1,548.82 Typical High $1,995.26 | Professional | None | $776.25 | $1,548.82 | $1,995.26 |
Hally Health Setting Professional Modifier None Typical Low $588.84 Median $977.24 Typical High $1,412.54 | Professional | None | $588.84 | $977.24 | $1,412.54 |
Medica Setting Facility Modifier None Typical Low $1,071.52 Median $1,905.46 Typical High $6,025.60 | Facility | None | $1,071.52 | $1,905.46 | $6,025.60 |
Medica Setting Professional Modifier None Typical Low $1,000.00 Median $1,659.59 Typical High $5,754.40 | Professional | None | $1,000.00 | $1,659.59 | $5,754.40 |
Midlands Setting Professional Modifier None Typical Low $1,445.44 Median $1,737.80 Typical High $1,949.84 | Professional | None | $1,445.44 | $1,737.80 | $1,949.84 |
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 $1,513.56 Median $1,513.56 Typical High $1,513.56 | Professional | None | $1,513.56 | $1,513.56 | $1,513.56 |
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 $724.44 Median $1,174.90 Typical High $2,089.30 | Professional | None | $724.44 | $1,174.90 | $2,089.30 |
Wellmark Setting Professional Modifier None Typical Low $1,148.15 Median $1,348.96 Typical High $1,905.46 | Professional | None | $1,148.15 | $1,348.96 | $1,905.46 |
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 $389.05 Median $575.44 Typical High $676.08 | Professional | 52 · Reduced service | $389.05 | $575.44 | $676.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $229.09 Typical High $269.15 | Professional | 53 · Discontinued | $154.88 | $229.09 | $269.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $851.14 Typical High $1,023.29 | Professional | 54 · Surgery only | $588.84 | $851.14 | $1,023.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $173.78 Typical High $204.17 | Professional | 55 · Aftercare only | $117.49 | $173.78 | $204.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $114.82 Typical High $134.90 | Professional | 56 · Pre-op care only | $77.62 | $114.82 | $134.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $794.33 Typical High $954.99 | Professional | 78 · Unplanned return to OR | $549.54 | $794.33 | $954.99 |
Where Iowa sits
The same service costs 3.7 times more in Alaska 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
AK $6,098WV $1,627
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.