How much rates vary
Facilitymedian $1,479 · 10th to 90th $479 to $2,188Professionalmedian $794 · 10th to 90th $417 to $1,380
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 $331.13 Median $501.19 Typical High $4,365.16 | Facility | None | $331.13 | $501.19 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $281.84 Median $407.38 Typical High $489.78 | Professional | None | $281.84 | $407.38 | $489.78 |
Cigna Setting Facility Modifier None Typical Low $724.44 Median $1,479.11 Typical High $2,187.76 | Facility | None | $724.44 | $1,479.11 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $645.65 Median $954.99 Typical High $1,258.93 | Professional | None | $645.65 | $954.99 | $1,258.93 |
Medica Setting Facility Modifier None Typical Low $478.63 Median $707.95 Typical High $1,698.24 | Facility | None | $478.63 | $707.95 | $1,698.24 |
Medica Setting Professional Modifier None Typical Low $426.58 Median $1,230.27 Typical High $3,630.78 | Professional | None | $426.58 | $1,230.27 | $3,630.78 |
Midlands Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $1,122.02 | Professional | None | $758.58 | $758.58 | $1,122.02 |
Midlands Setting Facility Modifier None Typical Low $954.99 Median $1,479.11 Typical High $2,238.72 | Facility | None | $954.99 | $1,479.11 | $2,238.72 |
Midlands Setting Professional Modifier None Typical Low $676.08 Median $724.44 Typical High $1,096.48 | Professional | None | $676.08 | $724.44 | $1,096.48 |
Sanford Health Plan Setting Professional Modifier None Typical Low $426.58 Median $645.65 Typical High $891.25 | Professional | None | $426.58 | $645.65 | $891.25 |
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 $389.05 Median $870.96 Typical High $1,380.38 | Professional | None | $389.05 | $870.96 | $1,380.38 |
Wellmark Setting Professional Modifier None Typical Low $676.08 Median $794.33 Typical High $1,258.93 | Professional | None | $676.08 | $794.33 | $1,258.93 |
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 $141.25 Median $208.93 Typical High $245.47 | Professional | 52 · Reduced service | $141.25 | $208.93 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $83.18 Typical High $100.00 | Professional | 53 · Discontinued | $56.23 | $83.18 | $100.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $316.23 Typical High $371.54 | Professional | 54 · Surgery only | $208.93 | $316.23 | $371.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $42.66 Median $63.10 Typical High $74.13 | Professional | 55 · Aftercare only | $42.66 | $63.10 | $74.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $41.69 Typical High $48.98 | Professional | 56 · Pre-op care only | $28.18 | $41.69 | $48.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $194.98 Median $295.12 Typical High $346.74 | Professional | 78 · Unplanned return to OR | $194.98 | $295.12 | $346.74 |
Where South Dakota 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.