How much rates vary
Facilitymedian $2,630 · 10th to 90th $661 to $7,586Professionalmedian $646 · 10th to 90th $407 to $1,096
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 $4,168.69 Typical High $7,244.36 | Facility | None | $602.56 | $4,168.69 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $269.15 Median $426.58 Typical High $660.69 | Professional | None | $269.15 | $426.58 | $660.69 |
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 $602.56 Median $691.83 Typical High $954.99 | Professional | None | $602.56 | $691.83 | $954.99 |
Hally Health Setting Professional Modifier None Typical Low $245.47 Median $512.86 Typical High $776.25 | Professional | None | $245.47 | $512.86 | $776.25 |
Medica Setting Facility Modifier None Typical Low $616.60 Median $1,174.90 Typical High $7,413.10 | Facility | None | $616.60 | $1,174.90 | $7,413.10 |
Medica Setting Professional Modifier None Typical Low $478.63 Median $812.83 Typical High $3,019.95 | Professional | None | $478.63 | $812.83 | $3,019.95 |
Midlands Setting Professional Modifier None Typical Low $512.86 Median $758.58 Typical High $954.99 | Professional | None | $512.86 | $758.58 | $954.99 |
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 $512.86 Median $831.76 Typical High $1,096.48 | Professional | None | $512.86 | $831.76 | $1,096.48 |
Oscar Health Setting Professional Modifier None Typical Low $269.15 Median $501.19 Typical High $831.76 | Professional | None | $269.15 | $501.19 | $831.76 |
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 $302.00 Median $512.86 Typical High $1,000.00 | Professional | None | $302.00 | $512.86 | $1,000.00 |
Wellmark Setting Professional Modifier None Typical Low $524.81 Median $616.60 Typical High $977.24 | Professional | None | $524.81 | $616.60 | $977.24 |
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 $134.90 Median $213.80 Typical High $316.23 | Professional | 52 · Reduced service | $134.90 | $213.80 | $316.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $53.70 Median $85.11 Typical High $125.89 | Professional | 53 · Discontinued | $53.70 | $85.11 | $125.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $204.17 Median $316.23 Typical High $478.63 | Professional | 54 · Surgery only | $204.17 | $316.23 | $478.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $64.57 Typical High $95.50 | Professional | 55 · Aftercare only | $40.74 | $64.57 | $95.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $42.66 Typical High $63.10 | Professional | 56 · Pre-op care only | $26.92 | $42.66 | $63.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $190.55 Median $295.12 Typical High $446.68 | Professional | 78 · Unplanned return to OR | $190.55 | $295.12 | $446.68 |
Where Iowa sits
The same service costs 6.3 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 $6,296MT $1,002
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.