How much rates vary
Facilitymedian $5,370 · 10th to 90th $1,000 to $15,136Professionalmedian $1,230 · 10th to 90th $617 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 $870.96 Median $4,265.80 Typical High $7,244.36 | Facility | None | $870.96 | $4,265.80 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $501.19 Median $870.96 Typical High $870.96 | Professional | None | $501.19 | $870.96 | $870.96 |
Cigna Setting Facility Modifier None Typical Low $1,096.48 Median $5,888.44 Typical High $7,244.36 | Facility | None | $1,096.48 | $5,888.44 | $7,244.36 |
Cigna Setting Professional Modifier None Typical Low $1,047.13 Median $1,258.93 Typical High $1,513.56 | Professional | None | $1,047.13 | $1,258.93 | $1,513.56 |
Hally Health Setting Professional Modifier None Typical Low $501.19 Median $831.76 Typical High $1,479.11 | Professional | None | $501.19 | $831.76 | $1,479.11 |
Medica Setting Facility Modifier None Typical Low $891.25 Median $4,677.35 Typical High $17,378.01 | Facility | None | $891.25 | $4,677.35 | $17,378.01 |
Medica Setting Professional Modifier None Typical Low $616.60 Median $1,258.93 Typical High $5,248.07 | Professional | None | $616.60 | $1,258.93 | $5,248.07 |
Midlands Setting Professional Modifier None Typical Low $1,071.52 Median $1,230.27 Typical High $1,479.11 | Professional | None | $1,071.52 | $1,230.27 | $1,479.11 |
Midlands Setting Facility Modifier None Typical Low $3,630.78 Median $5,888.44 Typical High $7,244.36 | Facility | None | $3,630.78 | $5,888.44 | $7,244.36 |
Midlands Setting Professional Modifier None Typical Low $1,047.13 Median $1,258.93 Typical High $1,905.46 | Professional | None | $1,047.13 | $1,258.93 | $1,905.46 |
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 $537.03 Median $812.83 Typical High $1,479.11 | Professional | None | $537.03 | $812.83 | $1,479.11 |
Wellmark Setting Professional Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $1,258.93 | Professional | None | $1,071.52 | $1,071.52 | $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 $251.19 Median $436.52 Typical High $436.52 | Professional | 52 · Reduced service | $251.19 | $436.52 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $173.78 Typical High $173.78 | Professional | 53 · Discontinued | $100.00 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $645.65 Typical High $645.65 | Professional | 54 · Surgery only | $380.19 | $645.65 | $645.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $128.82 Typical High $128.82 | Professional | 55 · Aftercare only | $75.86 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $87.10 Typical High $87.10 | Professional | 56 · Pre-op care only | $50.12 | $87.10 | $87.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $354.81 Median $602.56 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $354.81 | $602.56 | $602.56 |
Where Iowa sits
The same service costs 7.9 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 $13,941MT $1,762
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.