How much rates vary
Facilitymedian $209 · 10th to 90th $81 to $525Professionalmedian $155 · 10th to 90th $87 to $302
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 $288.40 Median $436.52 Typical High $645.65 | Facility | None | $288.40 | $436.52 | $645.65 |
Aetna Setting Professional Modifier None Typical Low $47.86 Median $89.13 Typical High $114.82 | Professional | None | $47.86 | $89.13 | $114.82 |
Cigna Setting Facility Modifier None Typical Low $79.43 Median $165.96 Typical High $208.93 | Facility | None | $79.43 | $165.96 | $208.93 |
Cigna Setting Professional Modifier None Typical Low $120.23 Median $190.55 Typical High $331.13 | Professional | None | $120.23 | $190.55 | $331.13 |
Medica Setting Facility Modifier None Typical Low $81.28 Median $138.04 Typical High $263.03 | Facility | None | $81.28 | $138.04 | $263.03 |
Medica Setting Professional Modifier None Typical Low $117.49 Median $269.15 Typical High $933.25 | Professional | None | $117.49 | $269.15 | $933.25 |
Midlands Setting Professional Modifier None Typical Low $134.90 Median $134.90 Typical High $245.47 | Professional | None | $134.90 | $134.90 | $245.47 |
Midlands Setting Facility Modifier None Typical Low $79.43 Median $79.43 Typical High $79.43 | Facility | None | $79.43 | $79.43 | $79.43 |
Midlands Setting Professional Modifier None Typical Low $123.03 Median $123.03 Typical High $223.87 | Professional | None | $123.03 | $123.03 | $223.87 |
Sanford Health Plan Setting Professional Modifier None Typical Low $97.72 Median $141.25 Typical High $223.87 | Professional | None | $97.72 | $141.25 | $223.87 |
United Setting Facility Modifier None Typical Low $125.89 Median $125.89 Typical High $223.87 | Facility | None | $125.89 | $125.89 | $223.87 |
United Setting Professional Modifier None Typical Low $69.18 Median $154.88 Typical High $302.00 | Professional | None | $69.18 | $154.88 | $302.00 |
Wellmark Setting Professional Modifier None Typical Low $114.82 Median $131.83 Typical High $316.23 | Professional | None | $114.82 | $131.83 | $316.23 |
5 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 $23.99 Median $43.65 Typical High $56.23 | Professional | 52 · Reduced service | $23.99 | $43.65 | $56.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.55 Median $17.78 Typical High $22.39 | Professional | 53 · Discontinued | $9.55 | $17.78 | $22.39 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $35.48 Median $66.07 Typical High $83.18 | Professional | 54 · Surgery only | $35.48 | $66.07 | $83.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.08 Median $13.18 Typical High $16.98 | Professional | 55 · Aftercare only | $7.08 | $13.18 | $16.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.79 Median $8.91 Typical High $11.22 | Professional | 56 · Pre-op care only | $4.79 | $8.91 | $11.22 |
Where South Dakota sits
The same service costs 12.9 times more in Colorado than in Maine. 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 $2,408ME $187
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.