How much rates vary
Facilitymedian $2,239 · 10th to 90th $776 to $6,761Professionalmedian $1,230 · 10th to 90th $631 to $1,660
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 $954.99 Median $4,265.80 Typical High $7,244.36 | Facility | None | $954.99 | $4,265.80 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $562.34 Median $954.99 Typical High $954.99 | Professional | None | $562.34 | $954.99 | $954.99 |
Cigna Setting Facility Modifier None Typical Low $1,096.48 Median $1,995.26 Typical High $2,454.71 | Facility | None | $1,096.48 | $1,995.26 | $2,454.71 |
Cigna Setting Professional Modifier None Typical Low $1,071.52 Median $1,412.54 Typical High $1,584.89 | Professional | None | $1,071.52 | $1,412.54 | $1,584.89 |
Hally Health Setting Professional Modifier None Typical Low $575.44 Median $724.44 Typical High $1,230.27 | Professional | None | $575.44 | $724.44 | $1,230.27 |
Medica Setting Facility Modifier None Typical Low $645.65 Median $1,698.24 Typical High $6,760.83 | Facility | None | $645.65 | $1,698.24 | $6,760.83 |
Medica Setting Professional Modifier None Typical Low $645.65 Median $1,230.27 Typical High $4,466.84 | Professional | None | $645.65 | $1,230.27 | $4,466.84 |
Midlands Setting Professional Modifier None Typical Low $1,202.26 Median $1,380.38 Typical High $1,584.89 | Professional | None | $1,202.26 | $1,380.38 | $1,584.89 |
Midlands Setting Facility Modifier None Typical Low $1,202.26 Median $1,995.26 Typical High $2,454.71 | Facility | None | $1,202.26 | $1,995.26 | $2,454.71 |
Midlands Setting Professional Modifier None Typical Low $1,174.90 Median $1,412.54 Typical High $1,584.89 | Professional | None | $1,174.90 | $1,412.54 | $1,584.89 |
United Setting Facility Modifier None Typical Low $724.44 Median $3,090.30 Typical High $7,762.47 | Facility | None | $724.44 | $3,090.30 | $7,762.47 |
United Setting Professional Modifier None Typical Low $588.84 Median $912.01 Typical High $1,621.81 | Professional | None | $588.84 | $912.01 | $1,621.81 |
Wellmark Setting Professional Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $1,445.44 | Professional | None | $1,230.27 | $1,230.27 | $1,445.44 |
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 $281.84 Median $478.63 Typical High $478.63 | Professional | 52 · Reduced service | $281.84 | $478.63 | $478.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $190.55 Typical High $190.55 | Professional | 53 · Discontinued | $112.20 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $416.87 Median $724.44 Typical High $724.44 | Professional | 54 · Surgery only | $416.87 | $724.44 | $724.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $144.54 Typical High $144.54 | Professional | 55 · Aftercare only | $83.18 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $95.50 Typical High $95.50 | Professional | 56 · Pre-op care only | $56.23 | $95.50 | $95.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $389.05 Median $676.08 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $389.05 | $676.08 | $676.08 |
Where Iowa sits
The same service costs 4.6 times more in Colorado than in Delaware. 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 $6,475DE $1,401
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.