How much rates vary
Facilitymedian $1,349 · 10th to 90th $513 to $2,138Professionalmedian $891 · 10th to 90th $468 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 $363.08 Median $562.34 Typical High $4,365.16 | Facility | None | $363.08 | $562.34 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $309.03 Median $467.74 Typical High $676.08 | Professional | None | $309.03 | $467.74 | $676.08 |
Cigna Setting Facility Modifier None Typical Low $794.33 Median $1,348.96 Typical High $2,137.96 | Facility | None | $794.33 | $1,348.96 | $2,137.96 |
Cigna Setting Professional Modifier None Typical Low $707.95 Median $1,071.52 Typical High $1,412.54 | Professional | None | $707.95 | $1,071.52 | $1,412.54 |
Medica Setting Facility Modifier None Typical Low $467.74 Median $776.25 Typical High $1,698.24 | Facility | None | $467.74 | $776.25 | $1,698.24 |
Medica Setting Professional Modifier None Typical Low $512.86 Median $1,380.38 Typical High $3,981.07 | Professional | None | $512.86 | $1,380.38 | $3,981.07 |
Midlands Setting Professional Modifier None Typical Low $831.76 Median $831.76 Typical High $1,258.93 | Professional | None | $831.76 | $831.76 | $1,258.93 |
Midlands Setting Facility Modifier None Typical Low $1,096.48 Median $1,445.44 Typical High $2,238.72 | Facility | None | $1,096.48 | $1,445.44 | $2,238.72 |
Midlands Setting Professional Modifier None Typical Low $741.31 Median $812.83 Typical High $1,258.93 | Professional | None | $741.31 | $812.83 | $1,258.93 |
Sanford Health Plan Setting Professional Modifier None Typical Low $467.74 Median $707.95 Typical High $1,000.00 | Professional | None | $467.74 | $707.95 | $1,000.00 |
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 $426.58 Median $954.99 Typical High $1,548.82 | Professional | None | $426.58 | $954.99 | $1,548.82 |
Wellmark Setting Professional Modifier None Typical Low $758.58 Median $891.25 Typical High $1,445.44 | Professional | None | $758.58 | $891.25 | $1,445.44 |
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 $151.36 Median $229.09 Typical High $275.42 | Professional | 52 · Reduced service | $151.36 | $229.09 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $61.66 Median $93.33 Typical High $109.65 | Professional | 53 · Discontinued | $61.66 | $93.33 | $109.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $229.09 Median $346.74 Typical High $416.87 | Professional | 54 · Surgery only | $229.09 | $346.74 | $416.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $45.71 Median $69.18 Typical High $83.18 | Professional | 55 · Aftercare only | $45.71 | $69.18 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $46.77 Typical High $54.95 | Professional | 56 · Pre-op care only | $30.90 | $46.77 | $54.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $213.80 Median $323.59 Typical High $389.05 | Professional | 78 · Unplanned return to OR | $213.80 | $323.59 | $389.05 |
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 $6,438MT $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.