How much rates vary
Facilitymedian $2,188 · 10th to 90th $933 to $6,918Professionalmedian $1,000 · 10th to 90th $603 to $1,549
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 $660.69 Median $3,388.44 Typical High $6,760.83 | Facility | None | $660.69 | $3,388.44 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $416.87 Median $660.69 Typical High $912.01 | Professional | None | $416.87 | $660.69 | $912.01 |
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 $933.25 Median $1,122.02 Typical High $1,380.38 | Professional | None | $933.25 | $1,122.02 | $1,380.38 |
Hally Health Setting Professional Modifier None Typical Low $380.19 Median $794.33 Typical High $977.24 | Professional | None | $380.19 | $794.33 | $977.24 |
Medica Setting Facility Modifier None Typical Low $851.14 Median $1,584.89 Typical High $6,760.83 | Facility | None | $851.14 | $1,584.89 | $6,760.83 |
Medica Setting Professional Modifier None Typical Low $676.08 Median $1,174.90 Typical High $4,365.16 | Professional | None | $676.08 | $1,174.90 | $4,365.16 |
Midlands Setting Professional Modifier None Typical Low $794.33 Median $1,122.02 Typical High $1,318.26 | Professional | None | $794.33 | $1,122.02 | $1,318.26 |
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 $794.33 Median $1,148.15 Typical High $1,513.56 | Professional | None | $794.33 | $1,148.15 | $1,513.56 |
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 $446.68 Median $724.44 Typical High $1,380.38 | Professional | None | $446.68 | $724.44 | $1,380.38 |
Wellmark Setting Professional Modifier None Typical Low $812.83 Median $954.99 Typical High $1,513.56 | Professional | None | $812.83 | $954.99 | $1,513.56 |
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 $208.93 Median $331.13 Typical High $457.09 | Professional | 52 · Reduced service | $208.93 | $331.13 | $457.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $131.83 Typical High $181.97 | Professional | 53 · Discontinued | $83.18 | $131.83 | $181.97 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $489.78 Typical High $691.83 | Professional | 54 · Surgery only | $309.03 | $489.78 | $691.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $97.72 Typical High $138.04 | Professional | 55 · Aftercare only | $61.66 | $97.72 | $138.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $66.07 Typical High $91.20 | Professional | 56 · Pre-op care only | $41.69 | $66.07 | $91.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $457.09 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $288.40 | $457.09 | $645.65 |
Where Iowa sits
The same service costs 4.4 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 $6,491MT $1,489
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.