How much rates vary
Facilitymedian $4,677 · 10th to 90th $1,288 to $13,804Professionalmedian $1,479 · 10th to 90th $813 to $2,042
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 $1,174.90 Median $4,365.16 Typical High $7,079.46 | Facility | None | $1,174.90 | $4,365.16 | $7,079.46 |
Aetna Setting Professional Modifier None Typical Low $691.83 Median $1,174.90 Typical High $1,862.09 | Professional | None | $691.83 | $1,174.90 | $1,862.09 |
Cigna Setting Facility Modifier None Typical Low $1,288.25 Median $5,888.44 Typical High $7,244.36 | Facility | None | $1,288.25 | $5,888.44 | $7,244.36 |
Cigna Setting Professional Modifier None Typical Low $1,445.44 Median $1,698.24 Typical High $2,041.74 | Professional | None | $1,445.44 | $1,698.24 | $2,041.74 |
Hally Health Setting Professional Modifier None Typical Low $691.83 Median $1,122.02 Typical High $1,995.26 | Professional | None | $691.83 | $1,122.02 | $1,995.26 |
Medica Setting Facility Modifier None Typical Low $1,071.52 Median $3,467.37 Typical High $17,378.01 | Facility | None | $1,071.52 | $3,467.37 | $17,378.01 |
Medica Setting Professional Modifier None Typical Low $851.14 Median $1,659.59 Typical High $12,022.64 | Professional | None | $851.14 | $1,659.59 | $12,022.64 |
Midlands Setting Professional Modifier None Typical Low $1,445.44 Median $1,698.24 Typical High $1,995.26 | Professional | None | $1,445.44 | $1,698.24 | $1,995.26 |
Midlands Setting Facility Modifier None Typical Low $3,388.44 Median $5,888.44 Typical High $7,244.36 | Facility | None | $3,388.44 | $5,888.44 | $7,244.36 |
Midlands Setting Professional Modifier None Typical Low $1,445.44 Median $1,698.24 Typical High $2,570.40 | Professional | None | $1,445.44 | $1,698.24 | $2,570.40 |
Oscar Health Setting Professional Modifier None Typical Low $707.95 Median $1,318.26 Typical High $1,659.59 | Professional | None | $707.95 | $1,318.26 | $1,659.59 |
United Setting Facility Modifier None Typical Low $1,584.89 Median $5,011.87 Typical High $19,054.61 | Facility | None | $1,584.89 | $5,011.87 | $19,054.61 |
United Setting Professional Modifier None Typical Low $741.31 Median $1,122.02 Typical High $2,041.74 | Professional | None | $741.31 | $1,122.02 | $2,041.74 |
Wellmark Setting Professional Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $1,737.80 | Professional | None | $1,479.11 | $1,479.11 | $1,737.80 |
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 $346.74 Median $588.84 Typical High $588.84 | Professional | 52 · Reduced service | $346.74 | $588.84 | $588.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $234.42 Typical High $234.42 | Professional | 53 · Discontinued | $138.04 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $891.25 Typical High $891.25 | Professional | 54 · Surgery only | $512.86 | $891.25 | $891.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $177.83 Typical High $177.83 | Professional | 55 · Aftercare only | $102.33 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $117.49 Typical High $117.49 | Professional | 56 · Pre-op care only | $69.18 | $117.49 | $117.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $831.76 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $478.63 | $831.76 | $831.76 |
Where Iowa sits
The same service costs 5.7 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 $13,613MT $2,377
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.