How much rates vary
Facilitymedian $5,012 · 10th to 90th $1,862 to $14,791Professionalmedian $2,042 · 10th to 90th $1,202 to $3,020
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 $1,659.59 Median $6,760.83 Typical High $10,471.29 | Facility | None | $1,659.59 | $6,760.83 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $977.24 Median $1,659.59 Typical High $2,570.40 | Professional | None | $977.24 | $1,659.59 | $2,570.40 |
Cigna Setting Facility Modifier None Typical Low $1,949.84 Median $5,888.44 Typical High $7,244.36 | Facility | None | $1,949.84 | $5,888.44 | $7,244.36 |
Cigna Setting Professional Modifier None Typical Low $2,041.74 Median $2,454.71 Typical High $2,951.21 | Professional | None | $2,041.74 | $2,454.71 | $2,951.21 |
Hally Health Setting Professional Modifier None Typical Low $977.24 Median $1,698.24 Typical High $2,951.21 | Professional | None | $977.24 | $1,698.24 | $2,951.21 |
Medica Setting Facility Modifier None Typical Low $1,905.46 Median $3,467.37 Typical High $17,378.01 | Facility | None | $1,905.46 | $3,467.37 | $17,378.01 |
Medica Setting Professional Modifier None Typical Low $1,202.26 Median $2,344.23 Typical High $7,943.28 | Professional | None | $1,202.26 | $2,344.23 | $7,943.28 |
Midlands Setting Professional Modifier None Typical Low $2,041.74 Median $2,398.83 Typical High $2,884.03 | Professional | None | $2,041.74 | $2,398.83 | $2,884.03 |
Midlands Setting Facility Modifier None Typical Low $3,388.44 Median $5,888.44 Typical High $7,244.36 | Facility | None | $3,388.44 | $5,888.44 | $7,244.36 |
Midlands Setting Professional Modifier None Typical Low $2,089.30 Median $2,344.23 Typical High $3,801.89 | Professional | None | $2,089.30 | $2,344.23 | $3,801.89 |
United Setting Facility Modifier None Typical Low $1,584.89 Median $5,011.87 Typical High $19,054.61 | Facility | None | $1,584.89 | $5,011.87 | $19,054.61 |
United Setting Professional Modifier None Typical Low $1,071.52 Median $1,621.81 Typical High $2,951.21 | Professional | None | $1,071.52 | $1,621.81 | $2,951.21 |
Wellmark Setting Professional Modifier None Typical Low $2,041.74 Median $2,041.74 Typical High $2,398.83 | Professional | None | $2,041.74 | $2,041.74 | $2,398.83 |
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 $489.78 Median $831.76 Typical High $831.76 | Professional | 52 · Reduced service | $489.78 | $831.76 | $831.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $194.98 Median $331.13 Typical High $331.13 | Professional | 53 · Discontinued | $194.98 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $1,258.93 Typical High $1,258.93 | Professional | 54 · Surgery only | $724.44 | $1,258.93 | $1,258.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $251.19 Typical High $251.19 | Professional | 55 · Aftercare only | $144.54 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $165.96 Typical High $165.96 | Professional | 56 · Pre-op care only | $97.72 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $1,174.90 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $676.08 | $1,174.90 | $1,174.90 |
Where Iowa sits
The same service costs 4.2 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 $14,362MT $3,396
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.