How much rates vary
Facilitymedian $891 · 10th to 90th $708 to $1,288Professionalmedian $1,122 · 10th to 90th $550 to $1,514
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 $549.54 Median $933.25 Typical High $3,090.30 | Facility | None | $549.54 | $933.25 | $3,090.30 |
Aetna Setting Professional Modifier None Typical Low $416.87 Median $467.74 Typical High $707.95 | Professional | None | $416.87 | $467.74 | $707.95 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $954.99 Typical High $1,122.02 | Facility | None | $776.25 | $954.99 | $1,122.02 |
Cigna Setting Professional Modifier None Typical Low $933.25 Median $1,174.90 Typical High $1,445.44 | Professional | None | $933.25 | $1,174.90 | $1,445.44 |
Medica Setting Facility Modifier None Typical Low $676.08 Median $794.33 Typical High $1,288.25 | Facility | None | $676.08 | $794.33 | $1,288.25 |
Medica Setting Professional Modifier None Typical Low $512.86 Median $1,318.26 Typical High $4,073.80 | Professional | None | $512.86 | $1,318.26 | $4,073.80 |
Midlands Setting Professional Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $1,230.27 | Professional | None | $1,122.02 | $1,122.02 | $1,230.27 |
Midlands Setting Facility Modifier None Typical Low $776.25 Median $954.99 Typical High $1,174.90 | Facility | None | $776.25 | $954.99 | $1,174.90 |
Midlands Setting Professional Modifier None Typical Low $1,023.29 Median $1,071.52 Typical High $1,202.26 | Professional | None | $1,023.29 | $1,071.52 | $1,202.26 |
Sanford Health Plan Setting Professional Modifier None Typical Low $676.08 Median $870.96 Typical High $1,096.48 | Professional | None | $676.08 | $870.96 | $1,096.48 |
United Setting Facility Modifier None Typical Low $758.58 Median $891.25 Typical High $1,698.24 | Facility | None | $758.58 | $891.25 | $1,698.24 |
United Setting Professional Modifier None Typical Low $478.63 Median $1,071.52 Typical High $1,513.56 | Professional | None | $478.63 | $1,071.52 | $1,513.56 |
Wellmark Setting Professional Modifier None Typical Low $1,047.13 Median $1,230.27 Typical High $1,548.82 | Professional | None | $1,047.13 | $1,230.27 | $1,548.82 |
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 $208.93 Median $234.42 Typical High $281.84 | Professional | 52 · Reduced service | $208.93 | $234.42 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $93.33 Typical High $112.20 | Professional | 53 · Discontinued | $83.18 | $93.33 | $112.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $354.81 Typical High $416.87 | Professional | 54 · Surgery only | $316.23 | $354.81 | $416.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $70.79 Typical High $83.18 | Professional | 55 · Aftercare only | $63.10 | $70.79 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $46.77 Typical High $56.23 | Professional | 56 · Pre-op care only | $41.69 | $46.77 | $56.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $295.12 Median $331.13 Typical High $389.05 | Professional | 78 · Unplanned return to OR | $295.12 | $331.13 | $389.05 |
Where South Dakota sits
The same service costs 4.0 times more in Colorado than in Alabama. 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 $5,057AL $1,277
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.