How much rates vary
Facilitymedian $224 · 10th to 90th $126 to $550Professionalmedian $589 · 10th to 90th $263 to $794
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 $257.04 Median $281.84 Typical High $4,365.16 | Facility | None | $257.04 | $281.84 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $223.87 Median $257.04 Typical High $426.58 | Professional | None | $223.87 | $257.04 | $426.58 |
Cigna Setting Facility Modifier None Typical Low $123.03 Median $173.78 Typical High $549.54 | Facility | None | $123.03 | $173.78 | $549.54 |
Cigna Setting Professional Modifier None Typical Low $501.19 Median $630.96 Typical High $794.33 | Professional | None | $501.19 | $630.96 | $794.33 |
Medica Setting Facility Modifier None Typical Low $125.89 Median $389.05 Typical High $630.96 | Facility | None | $125.89 | $389.05 | $630.96 |
Medica Setting Professional Modifier None Typical Low $257.04 Median $676.08 Typical High $2,238.72 | Professional | None | $257.04 | $676.08 | $2,238.72 |
Midlands Setting Professional Modifier None Typical Low $588.84 Median $588.84 Typical High $630.96 | Professional | None | $588.84 | $588.84 | $630.96 |
Midlands Setting Facility Modifier None Typical Low $123.03 Median $162.18 Typical High $218.78 | Facility | None | $123.03 | $162.18 | $218.78 |
Midlands Setting Professional Modifier None Typical Low $524.81 Median $562.34 Typical High $602.56 | Professional | None | $524.81 | $562.34 | $602.56 |
Sanford Health Plan Setting Professional Modifier None Typical Low $288.40 Median $457.09 Typical High $602.56 | Professional | None | $288.40 | $457.09 | $602.56 |
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 $245.47 Median $537.03 Typical High $776.25 | Professional | None | $245.47 | $537.03 | $776.25 |
Wellmark Setting Professional Modifier None Typical Low $660.69 Median $776.25 Typical High $933.25 | Professional | None | $660.69 | $776.25 | $933.25 |
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 $114.82 Median $128.82 Typical High $151.36 | Professional | 52 · Reduced service | $114.82 | $128.82 | $151.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $51.29 Typical High $60.26 | Professional | 53 · Discontinued | $45.71 | $51.29 | $60.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $173.78 Median $190.55 Typical High $229.09 | Professional | 54 · Surgery only | $173.78 | $190.55 | $229.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $38.02 Typical High $45.71 | Professional | 55 · Aftercare only | $34.67 | $38.02 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $25.70 Typical High $30.20 | Professional | 56 · Pre-op care only | $22.91 | $25.70 | $30.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $162.18 Median $177.83 Typical High $213.80 | Professional | 78 · Unplanned return to OR | $162.18 | $177.83 | $213.80 |
Where South Dakota sits
The same service costs 6.4 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 $2,602FL $408
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.