How much rates vary
Facilitymedian $1,318 · 10th to 90th $468 to $1,820Professionalmedian $776 · 10th to 90th $447 to $1,349
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 $323.59 Median $512.86 Typical High $4,365.16 | Facility | None | $323.59 | $512.86 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $275.42 Median $446.68 Typical High $512.86 | Professional | None | $275.42 | $446.68 | $512.86 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $1,318.26 Typical High $1,621.81 | Facility | None | $776.25 | $1,318.26 | $1,621.81 |
Cigna Setting Professional Modifier None Typical Low $676.08 Median $954.99 Typical High $1,548.82 | Professional | None | $676.08 | $954.99 | $1,548.82 |
Medica Setting Facility Modifier None Typical Low $467.74 Median $758.58 Typical High $1,698.24 | Facility | None | $467.74 | $758.58 | $1,698.24 |
Medica Setting Professional Modifier None Typical Low $446.68 Median $1,202.26 Typical High $3,890.45 | Professional | None | $446.68 | $1,202.26 | $3,890.45 |
Midlands Setting Professional Modifier None Typical Low $741.31 Median $776.25 Typical High $1,122.02 | Professional | None | $741.31 | $776.25 | $1,122.02 |
Midlands Setting Facility Modifier None Typical Low $954.99 Median $1,548.82 Typical High $1,698.24 | Facility | None | $954.99 | $1,548.82 | $1,698.24 |
Midlands Setting Professional Modifier None Typical Low $676.08 Median $676.08 Typical High $1,000.00 | Professional | None | $676.08 | $676.08 | $1,000.00 |
Sanford Health Plan Setting Professional Modifier None Typical Low $457.09 Median $691.83 Typical High $977.24 | Professional | None | $457.09 | $691.83 | $977.24 |
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 $380.19 Median $794.33 Typical High $1,412.54 | Professional | None | $380.19 | $794.33 | $1,412.54 |
Wellmark Setting Professional Modifier None Typical Low $630.96 Median $741.31 Typical High $1,318.26 | Professional | None | $630.96 | $741.31 | $1,318.26 |
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 $138.04 Median $223.87 Typical High $257.04 | Professional | 52 · Reduced service | $138.04 | $223.87 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $89.13 Typical High $102.33 | Professional | 53 · Discontinued | $54.95 | $89.13 | $102.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $331.13 Typical High $389.05 | Professional | 54 · Surgery only | $208.93 | $331.13 | $389.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $67.61 Typical High $77.62 | Professional | 55 · Aftercare only | $41.69 | $67.61 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $44.67 Typical High $51.29 | Professional | 56 · Pre-op care only | $27.54 | $44.67 | $51.29 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $194.98 Median $309.03 Typical High $363.08 | Professional | 78 · Unplanned return to OR | $194.98 | $309.03 | $363.08 |
Where South Dakota 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.