How much rates vary
Facilitymedian $1,230 · 10th to 90th $251 to $1,820Professionalmedian $407 · 10th to 90th $219 to $676
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 $173.78 Median $257.04 Typical High $4,365.16 | Facility | None | $173.78 | $257.04 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $147.91 Median $218.78 Typical High $309.03 | Professional | None | $147.91 | $218.78 | $309.03 |
Cigna Setting Facility Modifier None Typical Low $380.19 Median $1,230.27 Typical High $1,621.81 | Facility | None | $380.19 | $1,230.27 | $1,621.81 |
Cigna Setting Professional Modifier None Typical Low $363.08 Median $512.86 Typical High $758.58 | Professional | None | $363.08 | $512.86 | $758.58 |
Medica Setting Facility Modifier None Typical Low $251.19 Median $380.19 Typical High $1,698.24 | Facility | None | $251.19 | $380.19 | $1,698.24 |
Medica Setting Professional Modifier None Typical Low $223.87 Median $602.56 Typical High $1,949.84 | Professional | None | $223.87 | $602.56 | $1,949.84 |
Midlands Setting Professional Modifier None Typical Low $398.11 Median $407.38 Typical High $562.34 | Professional | None | $398.11 | $407.38 | $562.34 |
Midlands Setting Facility Modifier None Typical Low $954.99 Median $1,230.27 Typical High $1,698.24 | Facility | None | $954.99 | $1,230.27 | $1,698.24 |
Midlands Setting Professional Modifier None Typical Low $371.54 Median $371.54 Typical High $512.86 | Professional | None | $371.54 | $371.54 | $512.86 |
Sanford Health Plan Setting Professional Modifier None Typical Low $245.47 Median $354.81 Typical High $489.78 | Professional | None | $245.47 | $354.81 | $489.78 |
United Setting Facility Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $1,819.70 | Facility | None | $1,513.56 | $1,513.56 | $1,819.70 |
United Setting Professional Modifier None Typical Low $204.17 Median $398.11 Typical High $707.95 | Professional | None | $204.17 | $398.11 | $707.95 |
Wellmark Setting Professional Modifier None Typical Low $346.74 Median $407.38 Typical High $660.69 | Professional | None | $346.74 | $407.38 | $660.69 |
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 $74.13 Median $112.20 Typical High $128.82 | Professional | 52 · Reduced service | $74.13 | $112.20 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $29.51 Median $44.67 Typical High $51.29 | Professional | 53 · Discontinued | $29.51 | $44.67 | $51.29 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $112.20 Median $165.96 Typical High $194.98 | Professional | 54 · Surgery only | $112.20 | $165.96 | $194.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $33.11 Typical High $38.90 | Professional | 55 · Aftercare only | $22.39 | $33.11 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.79 Median $22.39 Typical High $25.70 | Professional | 56 · Pre-op care only | $14.79 | $22.39 | $25.70 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $104.71 Median $154.88 Typical High $181.97 | Professional | 78 · Unplanned return to OR | $104.71 | $154.88 | $181.97 |
Where South Dakota sits
The same service costs 9.3 times more in Colorado than in Montana. 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
CO $5,912MT $637
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.