How much rates vary
Facilitymedian $5,370 · 10th to 90th $1,096 to $15,136Professionalmedian $1,148 · 10th to 90th $631 to $1,622
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 $933.25 Median $4,265.80 Typical High $7,244.36 | Facility | None | $933.25 | $4,265.80 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $537.03 Median $933.25 Typical High $933.25 | Professional | None | $537.03 | $933.25 | $933.25 |
Cigna Setting Facility Modifier None Typical Low $1,096.48 Median $5,888.44 Typical High $7,244.36 | Facility | None | $1,096.48 | $5,888.44 | $7,244.36 |
Cigna Setting Professional Modifier None Typical Low $1,122.02 Median $1,348.96 Typical High $1,621.81 | Professional | None | $1,122.02 | $1,348.96 | $1,621.81 |
Hally Health Setting Professional Modifier None Typical Low $549.54 Median $912.01 Typical High $1,548.82 | Professional | None | $549.54 | $912.01 | $1,548.82 |
Medica Setting Facility Modifier None Typical Low $1,023.29 Median $4,677.35 Typical High $17,378.01 | Facility | None | $1,023.29 | $4,677.35 | $17,378.01 |
Medica Setting Professional Modifier None Typical Low $660.69 Median $1,318.26 Typical High $4,365.16 | Professional | None | $660.69 | $1,318.26 | $4,365.16 |
Midlands Setting Professional Modifier None Typical Low $1,148.15 Median $1,318.26 Typical High $1,584.89 | Professional | None | $1,148.15 | $1,318.26 | $1,584.89 |
Midlands Setting Facility Modifier None Typical Low $3,548.13 Median $5,888.44 Typical High $7,244.36 | Facility | None | $3,548.13 | $5,888.44 | $7,244.36 |
Midlands Setting Professional Modifier None Typical Low $1,122.02 Median $1,348.96 Typical High $1,995.26 | Professional | None | $1,122.02 | $1,348.96 | $1,995.26 |
Oscar Health Setting Professional Modifier None Typical Low $562.34 Median $1,047.13 Typical High $1,288.25 | Professional | None | $562.34 | $1,047.13 | $1,288.25 |
United Setting Facility Modifier None Typical Low $1,819.70 Median $6,309.57 Typical High $19,054.61 | Facility | None | $1,819.70 | $6,309.57 | $19,054.61 |
United Setting Professional Modifier None Typical Low $575.44 Median $891.25 Typical High $1,621.81 | Professional | None | $575.44 | $891.25 | $1,621.81 |
Wellmark Setting Professional Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $1,348.96 | Professional | None | $1,148.15 | $1,148.15 | $1,348.96 |
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 $269.15 Median $467.74 Typical High $467.74 | Professional | 52 · Reduced service | $269.15 | $467.74 | $467.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $186.21 Typical High $186.21 | Professional | 53 · Discontinued | $107.15 | $186.21 | $186.21 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $407.38 Median $691.83 Typical High $691.83 | Professional | 54 · Surgery only | $407.38 | $691.83 | $691.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $138.04 Typical High $138.04 | Professional | 55 · Aftercare only | $81.28 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $93.33 Typical High $93.33 | Professional | 56 · Pre-op care only | $53.70 | $93.33 | $93.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $380.19 Median $645.65 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $380.19 | $645.65 | $645.65 |
Where Iowa sits
The same service costs 7.4 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 $13,995MT $1,888
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.