How much rates vary
Facilitymedian $1,622 · 10th to 90th $302 to $2,754Professionalmedian $832 · 10th to 90th $245 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 $181.97 Median $812.83 Typical High $4,365.16 | Facility | None | $181.97 | $812.83 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $177.83 Median $257.04 Typical High $870.96 | Professional | None | $177.83 | $257.04 | $870.96 |
Cigna Setting Facility Modifier None Typical Low $1,096.48 Median $1,621.81 Typical High $2,754.23 | Facility | None | $1,096.48 | $1,621.81 | $2,754.23 |
Cigna Setting Professional Modifier None Typical Low $407.38 Median $588.84 Typical High $2,187.76 | Professional | None | $407.38 | $588.84 | $2,187.76 |
Medica Setting Facility Modifier None Typical Low $302.00 Median $1,318.26 Typical High $2,089.30 | Facility | None | $302.00 | $1,318.26 | $2,089.30 |
Medica Setting Professional Modifier None Typical Low $776.25 Median $2,187.76 Typical High $5,623.41 | Professional | None | $776.25 | $2,187.76 | $5,623.41 |
Midlands Setting Professional Modifier None Typical Low $426.58 Median $426.58 Typical High $1,698.24 | Professional | None | $426.58 | $426.58 | $1,698.24 |
Midlands Setting Facility Modifier None Typical Low $954.99 Median $1,621.81 Typical High $2,818.38 | Facility | None | $954.99 | $1,621.81 | $2,818.38 |
Sanford Health Plan Setting Professional Modifier None Typical Low $288.40 Median $1,023.29 Typical High $1,412.54 | Professional | None | $288.40 | $1,023.29 | $1,412.54 |
United Setting Facility Modifier None Typical Low $1,995.26 Median $1,995.26 Typical High $2,398.83 | Facility | None | $1,995.26 | $1,995.26 | $2,398.83 |
United Setting Professional Modifier None Typical Low $218.78 Median $512.86 Typical High $2,290.87 | Professional | None | $218.78 | $512.86 | $2,290.87 |
Wellmark Setting Professional Modifier None Typical Low $346.74 Median $416.87 Typical High $1,949.84 | Professional | None | $346.74 | $416.87 | $1,949.84 |
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 $89.13 Median $100.00 Typical High $426.58 | Professional | 52 · Reduced service | $89.13 | $100.00 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $39.81 Typical High $173.78 | Professional | 53 · Discontinued | $35.48 | $39.81 | $173.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $134.90 Median $151.36 Typical High $645.65 | Professional | 54 · Surgery only | $134.90 | $151.36 | $645.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $30.20 Typical High $128.82 | Professional | 55 · Aftercare only | $26.92 | $30.20 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $19.95 Typical High $85.11 | Professional | 56 · Pre-op care only | $17.78 | $19.95 | $85.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $125.89 Median $141.25 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $125.89 | $141.25 | $602.56 |
Where South Dakota 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.