How much rates vary
Facilitymedian $5,248 · 10th to 90th $1,047 to $14,791Professionalmedian $1,122 · 10th to 90th $589 to $1,549
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 $891.25 Median $4,265.80 Typical High $7,079.46 | Facility | None | $891.25 | $4,265.80 | $7,079.46 |
Aetna Setting Professional Modifier None Typical Low $524.81 Median $891.25 Typical High $1,380.38 | Professional | None | $524.81 | $891.25 | $1,380.38 |
Cigna Setting Facility Modifier None Typical Low $1,288.25 Median $7,762.47 Typical High $9,332.54 | Facility | None | $1,288.25 | $7,762.47 | $9,332.54 |
Cigna Setting Professional Modifier None Typical Low $1,071.52 Median $1,288.25 Typical High $1,548.82 | Professional | None | $1,071.52 | $1,288.25 | $1,548.82 |
Hally Health Setting Professional Modifier None Typical Low $512.86 Median $724.44 Typical High $1,230.27 | Professional | None | $512.86 | $724.44 | $1,230.27 |
Medica Setting Facility Modifier None Typical Low $831.76 Median $4,677.35 Typical High $17,378.01 | Facility | None | $831.76 | $4,677.35 | $17,378.01 |
Medica Setting Professional Modifier None Typical Low $616.60 Median $1,148.15 Typical High $4,265.80 | Professional | None | $616.60 | $1,148.15 | $4,265.80 |
Midlands Setting Professional Modifier None Typical Low $1,096.48 Median $1,258.93 Typical High $1,445.44 | Professional | None | $1,096.48 | $1,258.93 | $1,445.44 |
Midlands Setting Facility Modifier None Typical Low $3,548.13 Median $7,585.78 Typical High $9,332.54 | Facility | None | $3,548.13 | $7,585.78 | $9,332.54 |
Midlands Setting Professional Modifier None Typical Low $1,023.29 Median $1,348.96 Typical High $1,584.89 | Professional | None | $1,023.29 | $1,348.96 | $1,584.89 |
Oscar Health Setting Professional Modifier None Typical Low $537.03 Median $1,000.00 Typical High $1,230.27 | Professional | None | $537.03 | $1,000.00 | $1,230.27 |
United Setting Facility Modifier None Typical Low $1,819.70 Median $6,309.57 Typical High $19,054.61 | Facility | None | $1,819.70 | $6,309.57 | $19,054.61 |
United Setting Professional Modifier None Typical Low $549.54 Median $831.76 Typical High $1,513.56 | Professional | None | $549.54 | $831.76 | $1,513.56 |
Wellmark Setting Professional Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $1,318.26 | Professional | None | $1,122.02 | $1,122.02 | $1,318.26 |
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 $263.03 Median $446.68 Typical High $446.68 | Professional | 52 · Reduced service | $263.03 | $446.68 | $446.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $181.97 Typical High $181.97 | Professional | 53 · Discontinued | $104.71 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $398.11 Median $676.08 Typical High $676.08 | Professional | 54 · Surgery only | $398.11 | $676.08 | $676.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $134.90 Typical High $134.90 | Professional | 55 · Aftercare only | $79.43 | $134.90 | $134.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $89.13 Typical High $89.13 | Professional | 56 · Pre-op care only | $52.48 | $89.13 | $89.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $371.54 Median $630.96 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $371.54 | $630.96 | $630.96 |
Where Iowa sits
The same service costs 7.5 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 $13,659MT $1,825
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.