How much rates vary
Facilitymedian $2,754 · 10th to 90th $646 to $7,943Professionalmedian $603 · 10th to 90th $316 to $1,175
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 $602.56 Median $2,951.21 Typical High $6,760.83 | Facility | None | $602.56 | $2,951.21 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $251.19 Median $426.58 Typical High $562.34 | Professional | None | $251.19 | $426.58 | $562.34 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $2,630.27 Typical High $3,235.94 | Facility | None | $645.65 | $2,630.27 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $537.03 Median $616.60 Typical High $741.31 | Professional | None | $537.03 | $616.60 | $741.31 |
Hally Health Setting Professional Modifier None Typical Low $251.19 Median $436.52 Typical High $851.14 | Professional | None | $251.19 | $436.52 | $851.14 |
Medica Setting Facility Modifier None Typical Low $537.03 Median $1,659.59 Typical High $8,317.64 | Facility | None | $537.03 | $1,659.59 | $8,317.64 |
Medica Setting Professional Modifier None Typical Low $316.23 Median $645.65 Typical High $3,890.45 | Professional | None | $316.23 | $645.65 | $3,890.45 |
Midlands Setting Professional Modifier None Typical Low $524.81 Median $616.60 Typical High $741.31 | Professional | None | $524.81 | $616.60 | $741.31 |
Midlands Setting Facility Modifier None Typical Low $1,513.56 Median $2,630.27 Typical High $3,235.94 | Facility | None | $1,513.56 | $2,630.27 | $3,235.94 |
Midlands Setting Professional Modifier None Typical Low $549.54 Median $616.60 Typical High $1,071.52 | Professional | None | $549.54 | $616.60 | $1,071.52 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $3,630.78 Typical High $8,709.64 | Facility | None | $1,258.93 | $3,630.78 | $8,709.64 |
United Setting Professional Modifier None Typical Low $275.42 Median $426.58 Typical High $758.58 | Professional | None | $275.42 | $426.58 | $758.58 |
Wellmark Setting Professional Modifier None Typical Low $537.03 Median $537.03 Typical High $630.96 | Professional | None | $537.03 | $537.03 | $630.96 |
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 $125.89 Median $213.80 Typical High $213.80 | Professional | 52 · Reduced service | $125.89 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $50.12 Median $87.10 Typical High $87.10 | Professional | 53 · Discontinued | $50.12 | $87.10 | $87.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $186.21 Median $323.59 Typical High $323.59 | Professional | 54 · Surgery only | $186.21 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.02 Median $64.57 Typical High $64.57 | Professional | 55 · Aftercare only | $38.02 | $64.57 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.12 Median $42.66 Typical High $42.66 | Professional | 56 · Pre-op care only | $25.12 | $42.66 | $42.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $173.78 Median $302.00 Typical High $302.00 | Professional | 78 · Unplanned return to OR | $173.78 | $302.00 | $302.00 |
Where Iowa sits
The same service costs 7.3 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 $6,269MT $863
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.