How much rates vary
Facilitymedian $1,230 · 10th to 90th $562 to $1,820Professionalmedian $912 · 10th to 90th $468 to $1,445
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 $389.05 Median $537.03 Typical High $4,365.16 | Facility | None | $389.05 | $537.03 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $331.13 Median $446.68 Typical High $645.65 | Professional | None | $331.13 | $446.68 | $645.65 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $1,230.27 Typical High $1,621.81 | Facility | None | $758.58 | $1,230.27 | $1,621.81 |
Cigna Setting Professional Modifier None Typical Low $741.31 Median $1,023.29 Typical High $1,380.38 | Professional | None | $741.31 | $1,023.29 | $1,380.38 |
Medica Setting Facility Modifier None Typical Low $512.86 Median $758.58 Typical High $1,698.24 | Facility | None | $512.86 | $758.58 | $1,698.24 |
Medica Setting Professional Modifier None Typical Low $501.19 Median $1,288.25 Typical High $4,677.35 | Professional | None | $501.19 | $1,288.25 | $4,677.35 |
Midlands Setting Professional Modifier None Typical Low $891.25 Median $891.25 Typical High $1,202.26 | Professional | None | $891.25 | $891.25 | $1,202.26 |
Midlands Setting Facility Modifier None Typical Low $954.99 Median $1,230.27 Typical High $1,698.24 | Facility | None | $954.99 | $1,230.27 | $1,698.24 |
Midlands Setting Professional Modifier None Typical Low $812.83 Median $851.14 Typical High $1,174.90 | Professional | None | $812.83 | $851.14 | $1,174.90 |
Sanford Health Plan Setting Professional Modifier None Typical Low $512.86 Median $741.31 Typical High $977.24 | Professional | None | $512.86 | $741.31 | $977.24 |
United Setting Facility Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $1,819.70 | Facility | None | $1,513.56 | $1,513.56 | $1,819.70 |
United Setting Professional Modifier None Typical Low $446.68 Median $1,023.29 Typical High $1,479.11 | Professional | None | $446.68 | $1,023.29 | $1,479.11 |
Wellmark Setting Professional Modifier None Typical Low $812.83 Median $954.99 Typical High $1,380.38 | Professional | None | $812.83 | $954.99 | $1,380.38 |
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 $165.96 Median $223.87 Typical High $263.03 | Professional | 52 · Reduced service | $165.96 | $223.87 | $263.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $89.13 Typical High $104.71 | Professional | 53 · Discontinued | $66.07 | $89.13 | $104.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $338.84 Typical High $398.11 | Professional | 54 · Surgery only | $245.47 | $338.84 | $398.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $67.61 Typical High $79.43 | Professional | 55 · Aftercare only | $48.98 | $67.61 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $44.67 Typical High $52.48 | Professional | 56 · Pre-op care only | $33.11 | $44.67 | $52.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $229.09 Median $316.23 Typical High $371.54 | Professional | 78 · Unplanned return to OR | $229.09 | $316.23 | $371.54 |
Where South Dakota 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.