How much rates vary
Facilitymedian $2,344 · 10th to 90th $708 to $7,413Professionalmedian $724 · 10th to 90th $437 to $1,175
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 $1,318.26 Typical High $6,606.93 | Facility | None | $602.56 | $1,318.26 | $6,606.93 |
Aetna Setting Professional Modifier None Typical Low $302.00 Median $478.63 Typical High $933.25 | Professional | None | $302.00 | $478.63 | $933.25 |
Cigna Setting Facility Modifier None Typical Low $1,096.48 Median $2,630.27 Typical High $3,235.94 | Facility | None | $1,096.48 | $2,630.27 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $676.08 Median $758.58 Typical High $1,023.29 | Professional | None | $676.08 | $758.58 | $1,023.29 |
Hally Health Setting Professional Modifier None Typical Low $275.42 Median $562.34 Typical High $870.96 | Professional | None | $275.42 | $562.34 | $870.96 |
Medica Setting Facility Modifier None Typical Low $676.08 Median $1,230.27 Typical High $7,413.10 | Facility | None | $676.08 | $1,230.27 | $7,413.10 |
Medica Setting Professional Modifier None Typical Low $512.86 Median $851.14 Typical High $3,162.28 | Professional | None | $512.86 | $851.14 | $3,162.28 |
Midlands Setting Professional Modifier None Typical Low $575.44 Median $812.83 Typical High $1,023.29 | Professional | None | $575.44 | $812.83 | $1,023.29 |
Midlands Setting Facility Modifier None Typical Low $1,548.82 Median $2,630.27 Typical High $3,235.94 | Facility | None | $1,548.82 | $2,630.27 | $3,235.94 |
Midlands Setting Professional Modifier None Typical Low $562.34 Median $870.96 Typical High $1,174.90 | Professional | None | $562.34 | $870.96 | $1,174.90 |
Oscar Health Setting Professional Modifier None Typical Low $295.12 Median $549.54 Typical High $891.25 | Professional | None | $295.12 | $549.54 | $891.25 |
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 $331.13 Median $549.54 Typical High $1,047.13 | Professional | None | $331.13 | $549.54 | $1,047.13 |
Wellmark Setting Professional Modifier None Typical Low $575.44 Median $676.08 Typical High $1,047.13 | Professional | None | $575.44 | $676.08 | $1,047.13 |
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 $239.88 Typical High $338.84 | Professional | 52 · Reduced service | $151.36 | $239.88 | $338.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $60.26 Median $95.50 Typical High $134.90 | Professional | 53 · Discontinued | $60.26 | $95.50 | $134.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $223.87 Median $354.81 Typical High $501.19 | Professional | 54 · Surgery only | $223.87 | $354.81 | $501.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $45.71 Median $70.79 Typical High $100.00 | Professional | 55 · Aftercare only | $45.71 | $70.79 | $100.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $47.86 Typical High $67.61 | Professional | 56 · Pre-op care only | $30.20 | $47.86 | $67.61 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $213.80 Median $331.13 Typical High $467.74 | Professional | 78 · Unplanned return to OR | $213.80 | $331.13 | $467.74 |
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 $6,060MT $1,070
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.