How much rates vary
Facilitymedian $2,630 · 10th to 90th $851 to $7,586Professionalmedian $891 · 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 $602.56 Median $4,168.69 Typical High $7,244.36 | Facility | None | $602.56 | $4,168.69 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $371.54 Median $575.44 Typical High $1,047.13 | Professional | None | $371.54 | $575.44 | $1,047.13 |
Cigna Setting Facility Modifier None Typical Low $1,096.48 Median $2,630.27 Typical High $3,235.94 | Facility | None | $1,096.48 | $2,630.27 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $831.76 Median $954.99 Typical High $1,288.25 | Professional | None | $831.76 | $954.99 | $1,288.25 |
Hally Health Setting Professional Modifier None Typical Low $331.13 Median $724.44 Typical High $1,096.48 | Professional | None | $331.13 | $724.44 | $1,096.48 |
Medica Setting Facility Modifier None Typical Low $794.33 Median $1,548.82 Typical High $7,413.10 | Facility | None | $794.33 | $1,548.82 | $7,413.10 |
Medica Setting Professional Modifier None Typical Low $645.65 Median $1,071.52 Typical High $3,981.07 | Professional | None | $645.65 | $1,071.52 | $3,981.07 |
Midlands Setting Professional Modifier None Typical Low $707.95 Median $1,023.29 Typical High $1,258.93 | Professional | None | $707.95 | $1,023.29 | $1,258.93 |
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 $707.95 Median $1,096.48 Typical High $1,479.11 | Professional | None | $707.95 | $1,096.48 | $1,479.11 |
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 $416.87 Median $691.83 Typical High $1,318.26 | Professional | None | $416.87 | $691.83 | $1,318.26 |
Wellmark Setting Professional Modifier None Typical Low $724.44 Median $851.14 Typical High $1,380.38 | Professional | None | $724.44 | $851.14 | $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 $181.97 Median $288.40 Typical High $426.58 | Professional | 52 · Reduced service | $181.97 | $288.40 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $72.44 Median $114.82 Typical High $169.82 | Professional | 53 · Discontinued | $72.44 | $114.82 | $169.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $275.42 Median $436.52 Typical High $630.96 | Professional | 54 · Surgery only | $275.42 | $436.52 | $630.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $87.10 Typical High $125.89 | Professional | 55 · Aftercare only | $54.95 | $87.10 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $57.54 Typical High $85.11 | Professional | 56 · Pre-op care only | $36.31 | $57.54 | $85.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $257.04 Median $407.38 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $257.04 | $407.38 | $588.84 |
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 $6,438MT $1,383
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.