How much rates vary
Facilitymedian $617 · 10th to 90th $126 to $1,122Professionalmedian $933 · 10th to 90th $447 to $1,288
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 $416.87 Median $457.09 Typical High $4,365.16 | Facility | None | $416.87 | $457.09 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $371.54 Median $407.38 Typical High $489.78 | Professional | None | $371.54 | $407.38 | $489.78 |
Cigna Setting Facility Modifier None Typical Low $123.03 Median $707.95 Typical High $1,122.02 | Facility | None | $123.03 | $707.95 | $1,122.02 |
Cigna Setting Professional Modifier None Typical Low $794.33 Median $1,023.29 Typical High $1,288.25 | Professional | None | $794.33 | $1,023.29 | $1,288.25 |
Medica Setting Facility Modifier None Typical Low $125.89 Median $616.60 Typical High $812.83 | Facility | None | $125.89 | $616.60 | $812.83 |
Medica Setting Professional Modifier None Typical Low $407.38 Median $1,047.13 Typical High $3,548.13 | Professional | None | $407.38 | $1,047.13 | $3,548.13 |
Midlands Setting Professional Modifier None Typical Low $933.25 Median $933.25 Typical High $1,023.29 | Professional | None | $933.25 | $933.25 | $1,023.29 |
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 $794.33 Median $831.76 Typical High $933.25 | Professional | None | $794.33 | $831.76 | $933.25 |
Sanford Health Plan Setting Professional Modifier None Typical Low $467.74 Median $724.44 Typical High $954.99 | Professional | None | $467.74 | $724.44 | $954.99 |
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 $407.38 Median $831.76 Typical High $1,288.25 | Professional | None | $407.38 | $831.76 | $1,288.25 |
Wellmark Setting Professional Modifier None Typical Low $912.01 Median $1,071.52 Typical High $1,318.26 | Professional | None | $912.01 | $1,071.52 | $1,318.26 |
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 $186.21 Median $204.17 Typical High $245.47 | Professional | 52 · Reduced service | $186.21 | $204.17 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $74.13 Median $81.28 Typical High $97.72 | Professional | 53 · Discontinued | $74.13 | $81.28 | $97.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $275.42 Median $309.03 Typical High $363.08 | Professional | 54 · Surgery only | $275.42 | $309.03 | $363.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $61.66 Typical High $74.13 | Professional | 55 · Aftercare only | $54.95 | $61.66 | $74.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $40.74 Typical High $48.98 | Professional | 56 · Pre-op care only | $37.15 | $40.74 | $48.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $257.04 Median $288.40 Typical High $338.84 | Professional | 78 · Unplanned return to OR | $257.04 | $288.40 | $338.84 |
Where South Dakota sits
The same service costs 5.3 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 $4,377FL $831
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.