How much rates vary
Facilitymedian $2,630 · 10th to 90th $813 to $7,413Professionalmedian $813 · 10th to 90th $490 to $1,318
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 $331.13 Median $524.81 Typical High $891.25 | Professional | None | $331.13 | $524.81 | $891.25 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $2,630.27 Typical High $3,235.94 | Facility | None | $954.99 | $2,630.27 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $741.31 Median $891.25 Typical High $1,174.90 | Professional | None | $741.31 | $891.25 | $1,174.90 |
Hally Health Setting Professional Modifier None Typical Low $302.00 Median $630.96 Typical High $954.99 | Professional | None | $302.00 | $630.96 | $954.99 |
Medica Setting Facility Modifier None Typical Low $724.44 Median $1,380.38 Typical High $7,413.10 | Facility | None | $724.44 | $1,380.38 | $7,413.10 |
Medica Setting Professional Modifier None Typical Low $562.34 Median $933.25 Typical High $3,630.78 | Professional | None | $562.34 | $933.25 | $3,630.78 |
Midlands Setting Professional Modifier None Typical Low $630.96 Median $933.25 Typical High $1,122.02 | Professional | None | $630.96 | $933.25 | $1,122.02 |
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 $616.60 Median $977.24 Typical High $1,318.26 | Professional | None | $616.60 | $977.24 | $1,318.26 |
Oscar Health Setting Professional Modifier None Typical Low $338.84 Median $616.60 Typical High $1,047.13 | Professional | None | $338.84 | $616.60 | $1,047.13 |
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 $363.08 Median $602.56 Typical High $1,174.90 | Professional | None | $363.08 | $602.56 | $1,174.90 |
Wellmark Setting Professional Modifier None Typical Low $660.69 Median $776.25 Typical High $1,230.27 | Professional | None | $660.69 | $776.25 | $1,230.27 |
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 $165.96 Median $263.03 Typical High $380.19 | Professional | 52 · Reduced service | $165.96 | $263.03 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $104.71 Typical High $151.36 | Professional | 53 · Discontinued | $67.61 | $104.71 | $151.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $398.11 Typical High $575.44 | Professional | 54 · Surgery only | $251.19 | $398.11 | $575.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $79.43 Typical High $114.82 | Professional | 55 · Aftercare only | $50.12 | $79.43 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $52.48 Typical High $75.86 | Professional | 56 · Pre-op care only | $33.11 | $52.48 | $75.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $234.42 Median $371.54 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $234.42 | $371.54 | $537.03 |
Where Iowa sits
The same service costs 5.3 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 $6,378MT $1,213
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.