How much rates vary
Facilitymedian $2,188 · 10th to 90th $407 to $5,248Professionalmedian $457 · 10th to 90th $269 to $661
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 $602.56 Median $3,548.13 Typical High $6,760.83 | Facility | None | $602.56 | $3,548.13 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $208.93 Median $363.08 Typical High $363.08 | Professional | None | $208.93 | $363.08 | $363.08 |
Cigna Setting Facility Modifier None Typical Low $1,318.26 Median $1,659.59 Typical High $2,041.74 | Facility | None | $1,318.26 | $1,659.59 | $2,041.74 |
Cigna Setting Professional Modifier None Typical Low $426.58 Median $537.03 Typical High $645.65 | Professional | None | $426.58 | $537.03 | $645.65 |
Hally Health Setting Professional Modifier None Typical Low $218.78 Median $363.08 Typical High $630.96 | Professional | None | $218.78 | $363.08 | $630.96 |
Medica Setting Facility Modifier None Typical Low $316.23 Median $724.44 Typical High $4,786.30 | Facility | None | $316.23 | $724.44 | $4,786.30 |
Medica Setting Professional Modifier None Typical Low $269.15 Median $489.78 Typical High $1,819.70 | Professional | None | $269.15 | $489.78 | $1,819.70 |
Midlands Setting Professional Modifier None Typical Low $457.09 Median $537.03 Typical High $660.69 | Professional | None | $457.09 | $537.03 | $660.69 |
Midlands Setting Facility Modifier None Typical Low $1,412.54 Median $1,659.59 Typical High $1,819.70 | Facility | None | $1,412.54 | $1,659.59 | $1,819.70 |
Midlands Setting Professional Modifier None Typical Low $467.74 Median $489.78 Typical High $812.83 | Professional | None | $467.74 | $489.78 | $812.83 |
United Setting Facility Modifier None Typical Low $724.44 Median $2,884.03 Typical High $5,495.41 | Facility | None | $724.44 | $2,884.03 | $5,495.41 |
United Setting Professional Modifier None Typical Low $239.88 Median $354.81 Typical High $630.96 | Professional | None | $239.88 | $354.81 | $630.96 |
Wellmark Setting Professional Modifier None Typical Low $446.68 Median $446.68 Typical High $524.81 | Professional | None | $446.68 | $446.68 | $524.81 |
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 $102.33 Median $181.97 Typical High $181.97 | Professional | 52 · Reduced service | $102.33 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $72.44 Typical High $72.44 | Professional | 53 · Discontinued | $41.69 | $72.44 | $72.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $154.88 Median $269.15 Typical High $269.15 | Professional | 54 · Surgery only | $154.88 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $53.70 Typical High $53.70 | Professional | 55 · Aftercare only | $30.90 | $53.70 | $53.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $36.31 Typical High $36.31 | Professional | 56 · Pre-op care only | $20.89 | $36.31 | $36.31 |
Where Iowa sits
The same service costs 6.2 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 $4,689MT $752
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.