How much rates vary
Facilitymedian $2,188 · 10th to 90th $794 to $6,918Professionalmedian $759 · 10th to 90th $380 to $1,318
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 $602.56 Median $3,388.44 Typical High $6,760.83 | Facility | None | $602.56 | $3,388.44 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $316.23 Median $501.19 Typical High $794.33 | Professional | None | $316.23 | $501.19 | $794.33 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $1,995.26 Typical High $2,454.71 | Facility | None | $954.99 | $1,995.26 | $2,454.71 |
Cigna Setting Professional Modifier None Typical Low $758.58 Median $954.99 Typical High $1,380.38 | Professional | None | $758.58 | $954.99 | $1,380.38 |
Hally Health Setting Professional Modifier None Typical Low $309.03 Median $630.96 Typical High $912.01 | Professional | None | $309.03 | $630.96 | $912.01 |
Medica Setting Facility Modifier None Typical Low $741.31 Median $1,348.96 Typical High $6,760.83 | Facility | None | $741.31 | $1,348.96 | $6,760.83 |
Medica Setting Professional Modifier None Typical Low $489.78 Median $870.96 Typical High $2,454.71 | Professional | None | $489.78 | $870.96 | $2,454.71 |
Midlands Setting Professional Modifier None Typical Low $776.25 Median $977.24 Typical High $1,318.26 | Professional | None | $776.25 | $977.24 | $1,318.26 |
Midlands Setting Facility Modifier None Typical Low $1,230.27 Median $1,995.26 Typical High $2,454.71 | Facility | None | $1,230.27 | $1,995.26 | $2,454.71 |
Oscar Health Setting Professional Modifier None Typical Low $354.81 Median $660.69 Typical High $1,230.27 | Professional | None | $354.81 | $660.69 | $1,230.27 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $3,630.78 Typical High $7,762.47 | Facility | None | $1,258.93 | $3,630.78 | $7,762.47 |
United Setting Professional Modifier None Typical Low $354.81 Median $602.56 Typical High $1,174.90 | Professional | None | $354.81 | $602.56 | $1,174.90 |
Wellmark Setting Professional Modifier None Typical Low $630.96 Median $707.95 Typical High $1,148.15 | Professional | None | $630.96 | $707.95 | $1,148.15 |
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 $162.18 Median $251.19 Typical High $398.11 | Professional | 52 · Reduced service | $162.18 | $251.19 | $398.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $64.57 Median $102.33 Typical High $158.49 | Professional | 53 · Discontinued | $64.57 | $102.33 | $158.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $239.88 Median $380.19 Typical High $588.84 | Professional | 54 · Surgery only | $239.88 | $380.19 | $588.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $75.86 Typical High $117.49 | Professional | 55 · Aftercare only | $47.86 | $75.86 | $117.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $50.12 Typical High $79.43 | Professional | 56 · Pre-op care only | $32.36 | $50.12 | $79.43 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $223.87 Median $354.81 Typical High $549.54 | Professional | 78 · Unplanned return to OR | $223.87 | $354.81 | $549.54 |
Where Iowa sits
The same service costs 5.3 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 $6,438MT $1,226
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.