How much rates vary
Facilitymedian $1,698 · 10th to 90th $646 to $5,248Professionalmedian $692 · 10th to 90th $355 to $1,023
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 $602.56 Median $3,548.13 Typical High $6,760.83 | Facility | None | $602.56 | $3,548.13 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $302.00 Median $524.81 Typical High $794.33 | Professional | None | $302.00 | $524.81 | $794.33 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $1,445.44 Typical High $1,698.24 | Facility | None | $954.99 | $1,445.44 | $1,698.24 |
Cigna Setting Professional Modifier None Typical Low $616.60 Median $758.58 Typical High $912.01 | Professional | None | $616.60 | $758.58 | $912.01 |
Hally Health Setting Professional Modifier None Typical Low $302.00 Median $457.09 Typical High $776.25 | Professional | None | $302.00 | $457.09 | $776.25 |
Medica Setting Facility Modifier None Typical Low $524.81 Median $1,174.90 Typical High $4,897.79 | Facility | None | $524.81 | $1,174.90 | $4,897.79 |
Medica Setting Professional Modifier None Typical Low $354.81 Median $724.44 Typical High $3,388.44 | Professional | None | $354.81 | $724.44 | $3,388.44 |
Midlands Setting Professional Modifier None Typical Low $645.65 Median $724.44 Typical High $870.96 | Professional | None | $645.65 | $724.44 | $870.96 |
Midlands Setting Facility Modifier None Typical Low $954.99 Median $1,412.54 Typical High $1,698.24 | Facility | None | $954.99 | $1,412.54 | $1,698.24 |
Midlands Setting Professional Modifier None Typical Low $588.84 Median $758.58 Typical High $1,000.00 | Professional | None | $588.84 | $758.58 | $1,000.00 |
United Setting Facility Modifier None Typical Low $724.44 Median $2,884.03 Typical High $5,495.41 | Facility | None | $724.44 | $2,884.03 | $5,495.41 |
United Setting Professional Modifier None Typical Low $316.23 Median $489.78 Typical High $870.96 | Professional | None | $316.23 | $489.78 | $870.96 |
Wellmark Setting Professional Modifier None Typical Low $645.65 Median $645.65 Typical High $776.25 | Professional | None | $645.65 | $645.65 | $776.25 |
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 $151.36 Median $257.04 Typical High $257.04 | Professional | 52 · Reduced service | $151.36 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $60.26 Median $104.71 Typical High $104.71 | Professional | 53 · Discontinued | $60.26 | $104.71 | $104.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $229.09 Median $389.05 Typical High $389.05 | Professional | 54 · Surgery only | $229.09 | $389.05 | $389.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $45.71 Median $77.62 Typical High $77.62 | Professional | 55 · Aftercare only | $45.71 | $77.62 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $52.48 Typical High $52.48 | Professional | 56 · Pre-op care only | $30.20 | $52.48 | $52.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $213.80 Median $363.08 Typical High $363.08 | Professional | 78 · Unplanned return to OR | $213.80 | $363.08 | $363.08 |
Where Iowa sits
The same service costs 4.6 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 $4,822MT $1,050
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.