How much rates vary
Facilitymedian $5,370 · 10th to 90th $1,202 to $15,136Professionalmedian $1,288 · 10th to 90th $708 to $1,820
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 $1,047.13 Median $5,011.87 Typical High $7,244.36 | Facility | None | $1,047.13 | $5,011.87 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $616.60 Median $1,047.13 Typical High $1,548.82 | Professional | None | $616.60 | $1,047.13 | $1,548.82 |
Cigna Setting Facility Modifier None Typical Low $1,288.25 Median $5,888.44 Typical High $7,244.36 | Facility | None | $1,288.25 | $5,888.44 | $7,244.36 |
Cigna Setting Professional Modifier None Typical Low $1,258.93 Median $1,513.56 Typical High $1,819.70 | Professional | None | $1,258.93 | $1,513.56 | $1,819.70 |
Hally Health Setting Professional Modifier None Typical Low $616.60 Median $1,000.00 Typical High $1,778.28 | Professional | None | $616.60 | $1,000.00 | $1,778.28 |
Medica Setting Facility Modifier None Typical Low $933.25 Median $4,677.35 Typical High $17,378.01 | Facility | None | $933.25 | $4,677.35 | $17,378.01 |
Medica Setting Professional Modifier None Typical Low $741.31 Median $1,479.11 Typical High $4,897.79 | Professional | None | $741.31 | $1,479.11 | $4,897.79 |
Midlands Setting Professional Modifier None Typical Low $1,288.25 Median $1,479.11 Typical High $1,778.28 | Professional | None | $1,288.25 | $1,479.11 | $1,778.28 |
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 $1,258.93 Median $1,513.56 Typical High $2,238.72 | Professional | None | $1,258.93 | $1,513.56 | $2,238.72 |
Oscar Health Setting Professional Modifier None Typical Low $630.96 Median $1,174.90 Typical High $1,445.44 | Professional | None | $630.96 | $1,174.90 | $1,445.44 |
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 $645.65 Median $1,000.00 Typical High $1,819.70 | Professional | None | $645.65 | $1,000.00 | $1,819.70 |
Wellmark Setting Professional Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $1,513.56 | Professional | None | $1,288.25 | $1,288.25 | $1,513.56 |
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 $302.00 Median $524.81 Typical High $524.81 | Professional | 52 · Reduced service | $302.00 | $524.81 | $524.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $208.93 Typical High $208.93 | Professional | 53 · Discontinued | $123.03 | $208.93 | $208.93 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $794.33 Typical High $794.33 | Professional | 54 · Surgery only | $457.09 | $794.33 | $794.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $158.49 Typical High $158.49 | Professional | 55 · Aftercare only | $91.20 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $104.71 Typical High $104.71 | Professional | 56 · Pre-op care only | $61.66 | $104.71 | $104.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $741.31 Typical High $741.31 | Professional | 78 · Unplanned return to OR | $426.58 | $741.31 | $741.31 |
Where Iowa sits
The same service costs 6.5 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 $13,795MT $2,119
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.