How much rates vary
Facilitymedian $1,445 · 10th to 90th $490 to $2,239Professionalmedian $891 · 10th to 90th $501 to $1,698
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 $398.11 Median $645.65 Typical High $4,365.16 | Facility | None | $398.11 | $645.65 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $295.12 Median $457.09 Typical High $588.84 | Professional | None | $295.12 | $457.09 | $588.84 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $1,445.44 Typical High $2,238.72 | Facility | None | $776.25 | $1,445.44 | $2,238.72 |
Cigna Setting Professional Modifier None Typical Low $758.58 Median $1,000.00 Typical High $1,445.44 | Professional | None | $758.58 | $1,000.00 | $1,445.44 |
Medica Setting Facility Modifier None Typical Low $489.78 Median $776.25 Typical High $1,698.24 | Facility | None | $489.78 | $776.25 | $1,698.24 |
Medica Setting Professional Modifier None Typical Low $562.34 Median $1,548.82 Typical High $3,890.45 | Professional | None | $562.34 | $1,548.82 | $3,890.45 |
Midlands Setting Professional Modifier None Typical Low $891.25 Median $891.25 Typical High $1,445.44 | Professional | None | $891.25 | $891.25 | $1,445.44 |
Midlands Setting Facility Modifier None Typical Low $954.99 Median $1,445.44 Typical High $2,630.27 | Facility | None | $954.99 | $1,445.44 | $2,630.27 |
Midlands Setting Professional Modifier None Typical Low $812.83 Median $851.14 Typical High $1,380.38 | Professional | None | $812.83 | $851.14 | $1,380.38 |
Sanford Health Plan Setting Professional Modifier None Typical Low $446.68 Median $758.58 Typical High $1,023.29 | Professional | None | $446.68 | $758.58 | $1,023.29 |
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 $446.68 Median $1,047.13 Typical High $1,778.28 | Professional | None | $446.68 | $1,047.13 | $1,778.28 |
Wellmark Setting Professional Modifier None Typical Low $691.83 Median $812.83 Typical High $1,348.96 | Professional | None | $691.83 | $812.83 | $1,348.96 |
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 $147.91 Median $229.09 Typical High $269.15 | Professional | 52 · Reduced service | $147.91 | $229.09 | $269.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $58.88 Median $91.20 Typical High $107.15 | Professional | 53 · Discontinued | $58.88 | $91.20 | $107.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $218.78 Median $338.84 Typical High $398.11 | Professional | 54 · Surgery only | $218.78 | $338.84 | $398.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $43.65 Median $67.61 Typical High $79.43 | Professional | 55 · Aftercare only | $43.65 | $67.61 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $29.51 Median $45.71 Typical High $53.70 | Professional | 56 · Pre-op care only | $29.51 | $45.71 | $53.70 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $204.17 Median $316.23 Typical High $371.54 | Professional | 78 · Unplanned return to OR | $204.17 | $316.23 | $371.54 |
Where South Dakota 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.