How much rates vary
Facilitymedian $5,754 · 10th to 90th $1,259 to $15,136Professionalmedian $1,380 · 10th to 90th $794 to $1,995
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 $1,122.02 Median $4,265.80 Typical High $7,244.36 | Facility | None | $1,122.02 | $4,265.80 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $645.65 Median $1,122.02 Typical High $1,659.59 | Professional | None | $645.65 | $1,122.02 | $1,659.59 |
Cigna Setting Facility Modifier None Typical Low $1,096.48 Median $7,762.47 Typical High $9,549.93 | Facility | None | $1,096.48 | $7,762.47 | $9,549.93 |
Cigna Setting Professional Modifier None Typical Low $1,380.38 Median $1,621.81 Typical High $1,949.84 | Professional | None | $1,380.38 | $1,621.81 | $1,949.84 |
Hally Health Setting Professional Modifier None Typical Low $660.69 Median $1,122.02 Typical High $1,949.84 | Professional | None | $660.69 | $1,122.02 | $1,949.84 |
Medica Setting Facility Modifier None Typical Low $1,258.93 Median $4,677.35 Typical High $17,378.01 | Facility | None | $1,258.93 | $4,677.35 | $17,378.01 |
Medica Setting Professional Modifier None Typical Low $812.83 Median $1,584.89 Typical High $7,244.36 | Professional | None | $812.83 | $1,584.89 | $7,244.36 |
Midlands Setting Professional Modifier None Typical Low $1,380.38 Median $1,621.81 Typical High $1,949.84 | Professional | None | $1,380.38 | $1,621.81 | $1,949.84 |
Midlands Setting Facility Modifier None Typical Low $4,073.80 Median $7,762.47 Typical High $9,549.93 | Facility | None | $4,073.80 | $7,762.47 | $9,549.93 |
Midlands Setting Professional Modifier None Typical Low $1,380.38 Median $1,621.81 Typical High $2,454.71 | Professional | None | $1,380.38 | $1,621.81 | $2,454.71 |
United Setting Facility Modifier None Typical Low $1,819.70 Median $6,309.57 Typical High $19,054.61 | Facility | None | $1,819.70 | $6,309.57 | $19,054.61 |
United Setting Professional Modifier None Typical Low $707.95 Median $1,071.52 Typical High $1,949.84 | Professional | None | $707.95 | $1,071.52 | $1,949.84 |
Wellmark Setting Professional Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $1,621.81 | Professional | None | $1,380.38 | $1,380.38 | $1,621.81 |
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 $323.59 Median $562.34 Typical High $562.34 | Professional | 52 · Reduced service | $323.59 | $562.34 | $562.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $223.87 Typical High $223.87 | Professional | 53 · Discontinued | $131.83 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $831.76 Typical High $831.76 | Professional | 54 · Surgery only | $489.78 | $831.76 | $831.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $169.82 Typical High $169.82 | Professional | 55 · Aftercare only | $97.72 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $112.20 Typical High $112.20 | Professional | 56 · Pre-op care only | $64.57 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $457.09 Median $776.25 Typical High $776.25 | Professional | 78 · Unplanned return to OR | $457.09 | $776.25 | $776.25 |
Where Iowa sits
The same service costs 6.1 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 $13,882MT $2,270
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.