How much rates vary
Facilitymedian $1,479 · 10th to 90th $589 to $2,692Professionalmedian $977 · 10th to 90th $537 to $1,738
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 $398.11 Median $616.60 Typical High $4,365.16 | Facility | None | $398.11 | $616.60 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $346.74 Median $524.81 Typical High $758.58 | Professional | None | $346.74 | $524.81 | $758.58 |
Cigna Setting Facility Modifier None Typical Low $891.25 Median $1,479.11 Typical High $4,677.35 | Facility | None | $891.25 | $1,479.11 | $4,677.35 |
Cigna Setting Professional Modifier None Typical Low $794.33 Median $1,202.26 Typical High $1,548.82 | Professional | None | $794.33 | $1,202.26 | $1,548.82 |
Medica Setting Facility Modifier None Typical Low $588.84 Median $891.25 Typical High $1,698.24 | Facility | None | $588.84 | $891.25 | $1,698.24 |
Medica Setting Professional Modifier None Typical Low $549.54 Median $1,548.82 Typical High $4,570.88 | Professional | None | $549.54 | $1,548.82 | $4,570.88 |
Midlands Setting Professional Modifier None Typical Low $933.25 Median $933.25 Typical High $1,412.54 | Professional | None | $933.25 | $933.25 | $1,412.54 |
Midlands Setting Facility Modifier None Typical Low $1,288.25 Median $1,479.11 Typical High $5,011.87 | Facility | None | $1,288.25 | $1,479.11 | $5,011.87 |
Midlands Setting Professional Modifier None Typical Low $831.76 Median $912.01 Typical High $1,412.54 | Professional | None | $831.76 | $912.01 | $1,412.54 |
Sanford Health Plan Setting Professional Modifier None Typical Low $602.56 Median $812.83 Typical High $1,122.02 | Professional | None | $602.56 | $812.83 | $1,122.02 |
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 $478.63 Median $1,071.52 Typical High $1,737.80 | Professional | None | $478.63 | $1,071.52 | $1,737.80 |
Wellmark Setting Professional Modifier None Typical Low $831.76 Median $977.24 Typical High $1,621.81 | Professional | None | $831.76 | $977.24 | $1,621.81 |
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 $173.78 Median $263.03 Typical High $309.03 | Professional | 52 · Reduced service | $173.78 | $263.03 | $309.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $104.71 Typical High $123.03 | Professional | 53 · Discontinued | $69.18 | $104.71 | $123.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $389.05 Typical High $457.09 | Professional | 54 · Surgery only | $263.03 | $389.05 | $457.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $77.62 Typical High $91.20 | Professional | 55 · Aftercare only | $52.48 | $77.62 | $91.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $52.48 Typical High $61.66 | Professional | 56 · Pre-op care only | $34.67 | $52.48 | $61.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $245.47 Median $363.08 Typical High $426.58 | Professional | 78 · Unplanned return to OR | $245.47 | $363.08 | $426.58 |
Where South Dakota sits
The same service costs 6.5 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 $9,949MT $1,532
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.