How much rates vary
Facilitymedian $2,754 · 10th to 90th $851 to $7,413Professionalmedian $933 · 10th to 90th $562 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 $602.56 Median $3,388.44 Typical High $6,760.83 | Facility | None | $602.56 | $3,388.44 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $346.74 Median $549.54 Typical High $812.83 | Professional | None | $346.74 | $549.54 | $812.83 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $2,630.27 Typical High $3,467.37 | Facility | None | $954.99 | $2,630.27 | $3,467.37 |
Cigna Setting Professional Modifier None Typical Low $776.25 Median $954.99 Typical High $1,348.96 | Professional | None | $776.25 | $954.99 | $1,348.96 |
Hally Health Setting Professional Modifier None Typical Low $316.23 Median $691.83 Typical High $1,122.02 | Professional | None | $316.23 | $691.83 | $1,122.02 |
Medica Setting Facility Modifier None Typical Low $794.33 Median $1,584.89 Typical High $7,413.10 | Facility | None | $794.33 | $1,584.89 | $7,413.10 |
Medica Setting Professional Modifier None Typical Low $724.44 Median $1,148.15 Typical High $3,890.45 | Professional | None | $724.44 | $1,148.15 | $3,890.45 |
Midlands Setting Professional Modifier None Typical Low $660.69 Median $1,000.00 Typical High $1,348.96 | Professional | None | $660.69 | $1,000.00 | $1,348.96 |
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 $741.31 Median $1,202.26 Typical High $1,479.11 | Professional | None | $741.31 | $1,202.26 | $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 $426.58 Median $741.31 Typical High $1,479.11 | Professional | None | $426.58 | $741.31 | $1,479.11 |
Wellmark Setting Professional Modifier None Typical Low $676.08 Median $794.33 Typical High $1,318.26 | Professional | None | $676.08 | $794.33 | $1,318.26 |
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 $173.78 Median $269.15 Typical High $407.38 | Professional | 52 · Reduced service | $173.78 | $269.15 | $407.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $109.65 Typical High $162.18 | Professional | 53 · Discontinued | $69.18 | $109.65 | $162.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $257.04 Median $407.38 Typical High $616.60 | Professional | 54 · Surgery only | $257.04 | $407.38 | $616.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $51.29 Median $81.28 Typical High $123.03 | Professional | 55 · Aftercare only | $51.29 | $81.28 | $123.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $54.95 Typical High $81.28 | Professional | 56 · Pre-op care only | $34.67 | $54.95 | $81.28 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $239.88 Median $380.19 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $239.88 | $380.19 | $575.44 |
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 $6,451MT $1,460
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.