How much rates vary
Facilitymedian $3,020 · 10th to 90th $562 to $8,128Professionalmedian $871 · 10th to 90th $240 to $2,188
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 $354.81 Median $2,951.21 Typical High $6,760.83 | Facility | None | $354.81 | $2,951.21 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $186.21 Median $707.95 Typical High $1,174.90 | Professional | None | $186.21 | $707.95 | $1,174.90 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $3,090.30 Typical High $3,981.07 | Facility | None | $954.99 | $3,090.30 | $3,981.07 |
Cigna Setting Professional Modifier None Typical Low $407.38 Median $1,479.11 Typical High $2,187.76 | Professional | None | $407.38 | $1,479.11 | $2,187.76 |
Hally Health Setting Professional Modifier None Typical Low $165.96 Median $954.99 Typical High $1,445.44 | Professional | None | $165.96 | $954.99 | $1,445.44 |
Medica Setting Facility Modifier None Typical Low $478.63 Median $2,089.30 Typical High $8,317.64 | Facility | None | $478.63 | $2,089.30 | $8,317.64 |
Medica Setting Professional Modifier None Typical Low $398.11 Median $1,548.82 Typical High $2,951.21 | Professional | None | $398.11 | $1,548.82 | $2,951.21 |
Midlands Setting Professional Modifier None Typical Low $407.38 Median $1,659.59 Typical High $2,137.96 | Professional | None | $407.38 | $1,659.59 | $2,137.96 |
Midlands Setting Facility Modifier None Typical Low $1,778.28 Median $3,090.30 Typical High $3,981.07 | Facility | None | $1,778.28 | $3,090.30 | $3,981.07 |
Midlands Setting Professional Modifier None Typical Low $389.05 Median $616.60 Typical High $2,511.89 | Professional | None | $389.05 | $616.60 | $2,511.89 |
Oscar Health Setting Professional Modifier None Typical Low $181.97 Median $407.38 Typical High $1,548.82 | Professional | None | $181.97 | $407.38 | $1,548.82 |
United Setting Facility Modifier None Typical Low $1,380.38 Median $4,365.16 Typical High $9,772.37 | Facility | None | $1,380.38 | $4,365.16 | $9,772.37 |
United Setting Professional Modifier None Typical Low $213.80 Median $794.33 Typical High $2,238.72 | Professional | None | $213.80 | $794.33 | $2,238.72 |
Wellmark Setting Professional Modifier None Typical Low $346.74 Median $407.38 Typical High $1,862.09 | Professional | None | $346.74 | $407.38 | $1,862.09 |
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 $109.65 Median $147.91 Typical High $588.84 | Professional | 52 · Reduced service | $109.65 | $147.91 | $588.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $43.65 Median $58.88 Typical High $239.88 | Professional | 53 · Discontinued | $43.65 | $58.88 | $239.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $165.96 Median $223.87 Typical High $891.25 | Professional | 54 · Surgery only | $165.96 | $223.87 | $891.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.11 Median $44.67 Typical High $177.83 | Professional | 55 · Aftercare only | $33.11 | $44.67 | $177.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $29.51 Typical High $117.49 | Professional | 56 · Pre-op care only | $21.88 | $29.51 | $117.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $154.88 Median $208.93 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $154.88 | $208.93 | $831.76 |
Where Iowa sits
The same service costs 5.1 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 $7,315MT $1,443
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.