How much rates vary
Facilitymedian $2,754 · 10th to 90th $646 to $7,762Professionalmedian $741 · 10th to 90th $372 to $1,072
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 $5,011.87 Typical High $7,244.36 | Facility | None | $602.56 | $5,011.87 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $316.23 Median $549.54 Typical High $831.76 | Professional | None | $316.23 | $549.54 | $831.76 |
Cigna Setting Facility Modifier None Typical Low $1,202.26 Median $2,630.27 Typical High $3,235.94 | Facility | None | $1,202.26 | $2,630.27 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $645.65 Median $794.33 Typical High $954.99 | Professional | None | $645.65 | $794.33 | $954.99 |
Hally Health Setting Professional Modifier None Typical Low $316.23 Median $489.78 Typical High $831.76 | Professional | None | $316.23 | $489.78 | $831.76 |
Medica Setting Facility Modifier None Typical Low $549.54 Median $1,288.25 Typical High $7,943.28 | Facility | None | $549.54 | $1,288.25 | $7,943.28 |
Medica Setting Professional Modifier None Typical Low $371.54 Median $758.58 Typical High $3,630.78 | Professional | None | $371.54 | $758.58 | $3,630.78 |
Midlands Setting Professional Modifier None Typical Low $676.08 Median $758.58 Typical High $912.01 | Professional | None | $676.08 | $758.58 | $912.01 |
Midlands Setting Facility Modifier None Typical Low $1,288.25 Median $2,630.27 Typical High $3,235.94 | Facility | None | $1,288.25 | $2,630.27 | $3,235.94 |
Midlands Setting Professional Modifier None Typical Low $616.60 Median $812.83 Typical High $1,071.52 | Professional | None | $616.60 | $812.83 | $1,071.52 |
United Setting Facility Modifier None Typical Low $724.44 Median $3,090.30 Typical High $8,709.64 | Facility | None | $724.44 | $3,090.30 | $8,709.64 |
United Setting Professional Modifier None Typical Low $331.13 Median $501.19 Typical High $912.01 | Professional | None | $331.13 | $501.19 | $912.01 |
Wellmark Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $812.83 | Professional | None | $691.83 | $691.83 | $812.83 |
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 $158.49 Median $275.42 Typical High $275.42 | Professional | 52 · Reduced service | $158.49 | $275.42 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $109.65 Typical High $109.65 | Professional | 53 · Discontinued | $63.10 | $109.65 | $109.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $239.88 Median $407.38 Typical High $407.38 | Professional | 54 · Surgery only | $239.88 | $407.38 | $407.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $81.28 Typical High $81.28 | Professional | 55 · Aftercare only | $47.86 | $81.28 | $81.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $54.95 Typical High $54.95 | Professional | 56 · Pre-op care only | $31.62 | $54.95 | $54.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $223.87 Median $380.19 Typical High $380.19 | Professional | 78 · Unplanned return to OR | $223.87 | $380.19 | $380.19 |
Where Iowa sits
The same service costs 5.4 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 $6,102MT $1,125
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.