How much rates vary
Facilitymedian $741 · 10th to 90th $269 to $1,413Professionalmedian $1,148 · 10th to 90th $550 to $1,514
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 $269.15 Median $269.15 Typical High $4,365.16 | Facility | None | $269.15 | $269.15 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $436.52 Median $537.03 Typical High $741.31 | Professional | None | $436.52 | $537.03 | $741.31 |
Cigna Setting Facility Modifier None Typical Low $371.54 Median $1,023.29 Typical High $1,122.02 | Facility | None | $371.54 | $1,023.29 | $1,122.02 |
Cigna Setting Professional Modifier None Typical Low $912.01 Median $1,202.26 Typical High $1,548.82 | Professional | None | $912.01 | $1,202.26 | $1,548.82 |
Medica Setting Facility Modifier None Typical Low $446.68 Median $741.31 Typical High $1,318.26 | Facility | None | $446.68 | $741.31 | $1,318.26 |
Medica Setting Professional Modifier None Typical Low $562.34 Median $1,318.26 Typical High $4,073.80 | Professional | None | $562.34 | $1,318.26 | $4,073.80 |
Midlands Setting Professional Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $1,230.27 | Professional | None | $1,148.15 | $1,148.15 | $1,230.27 |
Midlands Setting Facility Modifier None Typical Low $371.54 Median $1,096.48 Typical High $1,174.90 | Facility | None | $371.54 | $1,096.48 | $1,174.90 |
Midlands Setting Professional Modifier None Typical Low $1,071.52 Median $1,122.02 Typical High $1,202.26 | Professional | None | $1,071.52 | $1,122.02 | $1,202.26 |
Sanford Health Plan Setting Professional Modifier None Typical Low $588.84 Median $912.01 Typical High $1,148.15 | Professional | None | $588.84 | $912.01 | $1,148.15 |
United Setting Facility Modifier None Typical Low $446.68 Median $537.03 Typical High $758.58 | Facility | None | $446.68 | $537.03 | $758.58 |
United Setting Professional Modifier None Typical Low $537.03 Median $1,071.52 Typical High $1,479.11 | Professional | None | $537.03 | $1,071.52 | $1,479.11 |
Wellmark Setting Professional Modifier None Typical Low $1,202.26 Median $1,380.38 Typical High $1,621.81 | Professional | None | $1,202.26 | $1,380.38 | $1,621.81 |
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 $234.42 Typical High $275.42 | Professional | 52 · Reduced service | $218.78 | $234.42 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $87.10 Median $93.33 Typical High $112.20 | Professional | 53 · Discontinued | $87.10 | $93.33 | $112.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $331.13 Median $354.81 Typical High $416.87 | Professional | 54 · Surgery only | $331.13 | $354.81 | $416.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $70.79 Typical High $83.18 | Professional | 55 · Aftercare only | $66.07 | $70.79 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $46.77 Typical High $56.23 | Professional | 56 · Pre-op care only | $43.65 | $46.77 | $56.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $309.03 Median $331.13 Typical High $389.05 | Professional | 78 · Unplanned return to OR | $309.03 | $331.13 | $389.05 |
Where South Dakota sits
The same service costs 4.0 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 $4,440FL $1,118
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.