How much rates vary
Facilitymedian $148 · 10th to 90th $107 to $355Professionalmedian $240 · 10th to 90th $145 to $468
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 $93.33 Median $165.96 Typical High $4,365.16 | Facility | None | $93.33 | $165.96 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $75.86 Median $141.25 Typical High $181.97 | Professional | None | $75.86 | $141.25 | $181.97 |
Cigna Setting Facility Modifier None Typical Low $79.43 Median $141.25 Typical High $309.03 | Facility | None | $79.43 | $141.25 | $309.03 |
Cigna Setting Professional Modifier None Typical Low $177.83 Median $251.19 Typical High $436.52 | Professional | None | $177.83 | $251.19 | $436.52 |
Medica Setting Facility Modifier None Typical Low $125.89 Median $204.17 Typical High $354.81 | Facility | None | $125.89 | $204.17 | $354.81 |
Medica Setting Professional Modifier None Typical Low $173.78 Median $398.11 Typical High $1,479.11 | Professional | None | $173.78 | $398.11 | $1,479.11 |
Midlands Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $371.54 | Professional | None | $213.80 | $213.80 | $371.54 |
Midlands Setting Facility Modifier None Typical Low $79.43 Median $134.90 Typical High $177.83 | Facility | None | $79.43 | $134.90 | $177.83 |
Midlands Setting Professional Modifier None Typical Low $194.98 Median $194.98 Typical High $346.74 | Professional | None | $194.98 | $194.98 | $346.74 |
Sanford Health Plan Setting Professional Modifier None Typical Low $151.36 Median $213.80 Typical High $338.84 | Professional | None | $151.36 | $213.80 | $338.84 |
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 $112.20 Median $245.47 Typical High $467.74 | Professional | None | $112.20 | $245.47 | $467.74 |
Wellmark Setting Professional Modifier None Typical Low $177.83 Median $208.93 Typical High $478.63 | Professional | None | $177.83 | $208.93 | $478.63 |
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 $37.15 Median $70.79 Typical High $83.18 | Professional | 52 · Reduced service | $37.15 | $70.79 | $83.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.14 Median $28.18 Typical High $33.88 | Professional | 53 · Discontinued | $15.14 | $28.18 | $33.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $56.23 Median $104.71 Typical High $125.89 | Professional | 54 · Surgery only | $56.23 | $104.71 | $125.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.22 Median $20.89 Typical High $25.12 | Professional | 55 · Aftercare only | $11.22 | $20.89 | $25.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.59 Median $14.13 Typical High $16.60 | Professional | 56 · Pre-op care only | $7.59 | $14.13 | $16.60 |
Where South Dakota sits
The same service costs 11.6 times more in Hawaii than in Maryland. 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
HI $3,027MD $261
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.