How much rates vary
Facilitymedian $692 · 10th to 90th $126 to $1,175Professionalmedian $1,148 · 10th to 90th $562 to $1,549
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 $501.19 Median $549.54 Typical High $4,365.16 | Facility | None | $501.19 | $549.54 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $436.52 Median $478.63 Typical High $575.44 | Professional | None | $436.52 | $478.63 | $575.44 |
Cigna Setting Facility Modifier None Typical Low $123.03 Median $851.14 Typical High $1,122.02 | Facility | None | $123.03 | $851.14 | $1,122.02 |
Cigna Setting Professional Modifier None Typical Low $954.99 Median $1,202.26 Typical High $1,659.59 | Professional | None | $954.99 | $1,202.26 | $1,659.59 |
Medica Setting Facility Modifier None Typical Low $125.89 Median $741.31 Typical High $812.83 | Facility | None | $125.89 | $741.31 | $812.83 |
Medica Setting Professional Modifier None Typical Low $501.19 Median $1,318.26 Typical High $4,265.80 | Professional | None | $501.19 | $1,318.26 | $4,265.80 |
Midlands Setting Professional Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $1,258.93 | Professional | None | $1,148.15 | $1,148.15 | $1,258.93 |
Midlands Setting Facility Modifier None Typical Low $123.03 Median $645.65 Typical High $1,174.90 | Facility | None | $123.03 | $645.65 | $1,174.90 |
Midlands Setting Professional Modifier None Typical Low $1,047.13 Median $1,096.48 Typical High $1,202.26 | Professional | None | $1,047.13 | $1,096.48 | $1,202.26 |
Sanford Health Plan Setting Professional Modifier None Typical Low $562.34 Median $912.01 Typical High $1,148.15 | Professional | None | $562.34 | $912.01 | $1,148.15 |
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 $489.78 Median $1,071.52 Typical High $1,513.56 | Professional | None | $489.78 | $1,071.52 | $1,513.56 |
Wellmark Setting Professional Modifier None Typical Low $1,071.52 Median $1,258.93 Typical High $1,584.89 | Professional | None | $1,071.52 | $1,258.93 | $1,584.89 |
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 $218.78 Median $239.88 Typical High $288.40 | Professional | 52 · Reduced service | $218.78 | $239.88 | $288.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $87.10 Median $97.72 Typical High $114.82 | Professional | 53 · Discontinued | $87.10 | $97.72 | $114.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $331.13 Median $363.08 Typical High $436.52 | Professional | 54 · Surgery only | $331.13 | $363.08 | $436.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $72.44 Typical High $87.10 | Professional | 55 · Aftercare only | $66.07 | $72.44 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $47.86 Typical High $57.54 | Professional | 56 · Pre-op care only | $43.65 | $47.86 | $57.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $309.03 Median $338.84 Typical High $407.38 | Professional | 78 · Unplanned return to OR | $309.03 | $338.84 | $407.38 |
Where South Dakota sits
The same service costs 4.8 times more in Colorado than in Florida. 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 $4,510FL $949
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.