How much rates vary
Facilitymedian $2,188 · 10th to 90th $891 to $6,918Professionalmedian $912 · 10th to 90th $550 to $1,479
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 $616.60 Median $3,388.44 Typical High $6,760.83 | Facility | None | $616.60 | $3,388.44 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $389.05 Median $616.60 Typical High $1,023.29 | Professional | None | $389.05 | $616.60 | $1,023.29 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $1,995.26 Typical High $2,454.71 | Facility | None | $954.99 | $1,995.26 | $2,454.71 |
Cigna Setting Professional Modifier None Typical Low $891.25 Median $977.24 Typical High $1,230.27 | Professional | None | $891.25 | $977.24 | $1,230.27 |
Hally Health Setting Professional Modifier None Typical Low $354.81 Median $707.95 Typical High $1,096.48 | Professional | None | $354.81 | $707.95 | $1,096.48 |
Medica Setting Facility Modifier None Typical Low $891.25 Median $1,445.44 Typical High $6,760.83 | Facility | None | $891.25 | $1,445.44 | $6,760.83 |
Medica Setting Professional Modifier None Typical Low $645.65 Median $1,148.15 Typical High $4,677.35 | Professional | None | $645.65 | $1,148.15 | $4,677.35 |
Midlands Setting Professional Modifier None Typical Low $758.58 Median $1,000.00 Typical High $1,202.26 | Professional | None | $758.58 | $1,000.00 | $1,202.26 |
Midlands Setting Facility Modifier None Typical Low $1,230.27 Median $1,995.26 Typical High $2,454.71 | Facility | None | $1,230.27 | $1,995.26 | $2,454.71 |
Midlands Setting Professional Modifier None Typical Low $758.58 Median $1,071.52 Typical High $1,479.11 | Professional | None | $758.58 | $1,071.52 | $1,479.11 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $3,630.78 Typical High $7,762.47 | Facility | None | $1,258.93 | $3,630.78 | $7,762.47 |
United Setting Professional Modifier None Typical Low $426.58 Median $676.08 Typical High $1,258.93 | Professional | None | $426.58 | $676.08 | $1,258.93 |
Wellmark Setting Professional Modifier None Typical Low $776.25 Median $912.01 Typical High $1,348.96 | Professional | None | $776.25 | $912.01 | $1,348.96 |
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 $194.98 Median $309.03 Typical High $407.38 | Professional | 52 · Reduced service | $194.98 | $309.03 | $407.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $77.62 Median $123.03 Typical High $162.18 | Professional | 53 · Discontinued | $77.62 | $123.03 | $162.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $295.12 Median $457.09 Typical High $616.60 | Professional | 54 · Surgery only | $295.12 | $457.09 | $616.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $91.20 Typical High $123.03 | Professional | 55 · Aftercare only | $58.88 | $91.20 | $123.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $61.66 Typical High $81.28 | Professional | 56 · Pre-op care only | $38.90 | $61.66 | $81.28 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $275.42 Median $426.58 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $275.42 | $426.58 | $575.44 |
Where Iowa sits
The same service costs 4.7 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 $6,464MT $1,390
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.