How much rates vary
Facilitymedian $3,090 · 10th to 90th $1,349 to $9,120Professionalmedian $1,862 · 10th to 90th $1,023 to $2,884
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 $1,621.81 Median $4,265.80 Typical High $7,244.36 | Facility | None | $1,621.81 | $4,265.80 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $933.25 Median $1,621.81 Typical High $1,621.81 | Professional | None | $933.25 | $1,621.81 | $1,621.81 |
Cigna Setting Facility Modifier None Typical Low $1,096.48 Median $2,754.23 Typical High $3,388.44 | Facility | None | $1,096.48 | $2,754.23 | $3,388.44 |
Cigna Setting Professional Modifier None Typical Low $1,096.48 Median $1,949.84 Typical High $2,691.53 | Professional | None | $1,096.48 | $1,949.84 | $2,691.53 |
Hally Health Setting Professional Modifier None Typical Low $831.76 Median $1,202.26 Typical High $2,187.76 | Professional | None | $831.76 | $1,202.26 | $2,187.76 |
Medica Setting Facility Modifier None Typical Low $1,348.96 Median $2,570.40 Typical High $9,120.11 | Facility | None | $1,348.96 | $2,570.40 | $9,120.11 |
Medica Setting Professional Modifier None Typical Low $1,122.02 Median $1,995.26 Typical High $7,244.36 | Professional | None | $1,122.02 | $1,995.26 | $7,244.36 |
Midlands Setting Professional Modifier None Typical Low $1,949.84 Median $1,949.84 Typical High $2,511.89 | Professional | None | $1,949.84 | $1,949.84 | $2,511.89 |
Midlands Setting Facility Modifier None Typical Low $1,380.38 Median $2,691.53 Typical High $3,388.44 | Facility | None | $1,380.38 | $2,691.53 | $3,388.44 |
Midlands Setting Professional Modifier None Typical Low $1,862.09 Median $1,862.09 Typical High $1,862.09 | Professional | None | $1,862.09 | $1,862.09 | $1,862.09 |
United Setting Facility Modifier None Typical Low $1,380.38 Median $4,365.16 Typical High $10,471.29 | Facility | None | $1,380.38 | $4,365.16 | $10,471.29 |
United Setting Professional Modifier None Typical Low $977.24 Median $1,412.54 Typical High $2,630.27 | Professional | None | $977.24 | $1,412.54 | $2,630.27 |
Wellmark Setting Professional Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $1,905.46 | Professional | None | $1,621.81 | $1,621.81 | $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 $478.63 Median $812.83 Typical High $812.83 | Professional | 52 · Reduced service | $478.63 | $812.83 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $190.55 Median $323.59 Typical High $323.59 | Professional | 53 · Discontinued | $190.55 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $1,202.26 Typical High $1,202.26 | Professional | 54 · Surgery only | $724.44 | $1,202.26 | $1,202.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $239.88 Typical High $239.88 | Professional | 55 · Aftercare only | $144.54 | $239.88 | $239.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $162.18 Typical High $162.18 | Professional | 56 · Pre-op care only | $95.50 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $1,122.02 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $676.08 | $1,122.02 | $1,122.02 |
Where Iowa sits
The same service costs 3.1 times more in Wisconsin than in Florida. 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
WI $8,254FL $2,626
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.