How much rates vary
Facilitymedian $1,349 · 10th to 90th $389 to $2,138Professionalmedian $646 · 10th to 90th $363 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 $269.15 Median $426.58 Typical High $4,365.16 | Facility | None | $269.15 | $426.58 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $229.09 Median $346.74 Typical High $426.58 | Professional | None | $229.09 | $346.74 | $426.58 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,348.96 Typical High $2,137.96 | Facility | None | $602.56 | $1,348.96 | $2,137.96 |
Cigna Setting Professional Modifier None Typical Low $524.81 Median $794.33 Typical High $1,071.52 | Professional | None | $524.81 | $794.33 | $1,071.52 |
Medica Setting Facility Modifier None Typical Low $389.05 Median $588.84 Typical High $1,698.24 | Facility | None | $389.05 | $588.84 | $1,698.24 |
Medica Setting Professional Modifier None Typical Low $363.08 Median $1,047.13 Typical High $3,019.95 | Professional | None | $363.08 | $1,047.13 | $3,019.95 |
Midlands Setting Professional Modifier None Typical Low $616.60 Median $616.60 Typical High $954.99 | Professional | None | $616.60 | $616.60 | $954.99 |
Midlands Setting Facility Modifier None Typical Low $1,096.48 Median $1,479.11 Typical High $2,238.72 | Facility | None | $1,096.48 | $1,479.11 | $2,238.72 |
Midlands Setting Professional Modifier None Typical Low $549.54 Median $602.56 Typical High $933.25 | Professional | None | $549.54 | $602.56 | $933.25 |
Sanford Health Plan Setting Professional Modifier None Typical Low $398.11 Median $524.81 Typical High $741.31 | Professional | None | $398.11 | $524.81 | $741.31 |
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 $316.23 Median $724.44 Typical High $1,174.90 | Professional | None | $316.23 | $724.44 | $1,174.90 |
Wellmark Setting Professional Modifier None Typical Low $549.54 Median $645.65 Typical High $1,023.29 | Professional | None | $549.54 | $645.65 | $1,023.29 |
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 $114.82 Median $173.78 Typical High $204.17 | Professional | 52 · Reduced service | $114.82 | $173.78 | $204.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $69.18 Typical High $81.28 | Professional | 53 · Discontinued | $45.71 | $69.18 | $81.28 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $169.82 Median $263.03 Typical High $309.03 | Professional | 54 · Surgery only | $169.82 | $263.03 | $309.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $52.48 Typical High $61.66 | Professional | 55 · Aftercare only | $33.88 | $52.48 | $61.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $34.67 Typical High $40.74 | Professional | 56 · Pre-op care only | $22.91 | $34.67 | $40.74 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $158.49 Median $245.47 Typical High $288.40 | Professional | 78 · Unplanned return to OR | $158.49 | $245.47 | $288.40 |
Where South Dakota 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.