How much rates vary
Facilitymedian $759 · 10th to 90th $302 to $1,698Professionalmedian $525 · 10th to 90th $288 to $912
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 $223.87 Median $338.84 Typical High $4,365.16 | Facility | None | $223.87 | $338.84 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $181.97 Median $288.40 Typical High $338.84 | Professional | None | $181.97 | $288.40 | $338.84 |
Cigna Setting Facility Modifier None Typical Low $363.08 Median $616.60 Typical High $1,513.56 | Facility | None | $363.08 | $616.60 | $1,513.56 |
Cigna Setting Professional Modifier None Typical Low $436.52 Median $616.60 Typical High $794.33 | Professional | None | $436.52 | $616.60 | $794.33 |
Medica Setting Facility Modifier None Typical Low $302.00 Median $478.63 Typical High $1,202.26 | Facility | None | $302.00 | $478.63 | $1,202.26 |
Medica Setting Professional Modifier None Typical Low $346.74 Median $758.58 Typical High $1,621.81 | Professional | None | $346.74 | $758.58 | $1,621.81 |
Midlands Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $758.58 | Professional | None | $524.81 | $524.81 | $758.58 |
Midlands Setting Facility Modifier None Typical Low $363.08 Median $1,348.96 Typical High $1,949.84 | Facility | None | $363.08 | $1,348.96 | $1,949.84 |
Midlands Setting Professional Modifier None Typical Low $457.09 Median $457.09 Typical High $630.96 | Professional | None | $457.09 | $457.09 | $630.96 |
Sanford Health Plan Setting Professional Modifier None Typical Low $323.59 Median $478.63 Typical High $660.69 | Professional | None | $323.59 | $478.63 | $660.69 |
United Setting Facility Modifier None Typical Low $758.58 Median $891.25 Typical High $1,698.24 | Facility | None | $758.58 | $891.25 | $1,698.24 |
United Setting Professional Modifier None Typical Low $263.03 Median $512.86 Typical High $954.99 | Professional | None | $263.03 | $512.86 | $954.99 |
Wellmark Setting Professional Modifier None Typical Low $389.05 Median $457.09 Typical High $831.76 | Professional | None | $389.05 | $457.09 | $831.76 |
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 $91.20 Median $144.54 Typical High $169.82 | Professional | 52 · Reduced service | $91.20 | $144.54 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $57.54 Typical High $67.61 | Professional | 53 · Discontinued | $36.31 | $57.54 | $67.61 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $134.90 Median $213.80 Typical High $251.19 | Professional | 54 · Surgery only | $134.90 | $213.80 | $251.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $42.66 Typical High $50.12 | Professional | 55 · Aftercare only | $26.92 | $42.66 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $28.84 Typical High $33.88 | Professional | 56 · Pre-op care only | $18.20 | $28.84 | $33.88 |
Where South Dakota sits
The same service costs 6.1 times more in Michigan 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
MI $4,783MT $790
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.