How much rates vary
Facilitymedian $2,188 · 10th to 90th $676 to $6,918Professionalmedian $617 · 10th to 90th $331 to $1,023
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 $478.63 Median $3,311.31 Typical High $6,760.83 | Facility | None | $478.63 | $3,311.31 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $281.84 Median $446.68 Typical High $616.60 | Professional | None | $281.84 | $446.68 | $616.60 |
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 $645.65 Median $831.76 Typical High $1,096.48 | Professional | None | $645.65 | $831.76 | $1,096.48 |
Hally Health Setting Professional Modifier None Typical Low $269.15 Median $501.19 Typical High $724.44 | Professional | None | $269.15 | $501.19 | $724.44 |
Medica Setting Facility Modifier None Typical Low $630.96 Median $1,122.02 Typical High $6,918.31 | Facility | None | $630.96 | $1,122.02 | $6,918.31 |
Medica Setting Professional Modifier None Typical Low $467.74 Median $758.58 Typical High $2,137.96 | Professional | None | $467.74 | $758.58 | $2,137.96 |
Midlands Setting Professional Modifier None Typical Low $660.69 Median $776.25 Typical High $1,047.13 | Professional | None | $660.69 | $776.25 | $1,047.13 |
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 $281.84 Median $512.86 Typical High $912.01 | Professional | None | $281.84 | $512.86 | $912.01 |
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 $331.13 Median $512.86 Typical High $1,000.00 | Professional | None | $331.13 | $512.86 | $1,000.00 |
Wellmark Setting Professional Modifier None Typical Low $501.19 Median $562.34 Typical High $831.76 | Professional | None | $501.19 | $562.34 | $831.76 |
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 $218.78 Typical High $309.03 | Professional | 52 · Reduced service | $138.04 | $218.78 | $309.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $89.13 Typical High $123.03 | Professional | 53 · Discontinued | $56.23 | $89.13 | $123.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $331.13 Typical High $457.09 | Professional | 54 · Surgery only | $208.93 | $331.13 | $457.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $66.07 Typical High $93.33 | Professional | 55 · Aftercare only | $41.69 | $66.07 | $93.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $44.67 Typical High $61.66 | Professional | 56 · Pre-op care only | $28.18 | $44.67 | $61.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $194.98 Median $309.03 Typical High $426.58 | Professional | 78 · Unplanned return to OR | $194.98 | $309.03 | $426.58 |
Where Iowa sits
The same service costs 6.1 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 $6,346MT $1,043
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.