How much rates vary
Facilitymedian $1,096 · 10th to 90th $295 to $2,399Professionalmedian $661 · 10th to 90th $263 to $1,698
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 $645.65 Typical High $4,365.16 | Facility | None | $181.97 | $645.65 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $177.83 Median $199.53 Typical High $660.69 | Professional | None | $177.83 | $199.53 | $660.69 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $1,071.52 Typical High $1,621.81 | Facility | None | $691.83 | $1,071.52 | $1,621.81 |
Cigna Setting Professional Modifier None Typical Low $407.38 Median $501.19 Typical High $1,698.24 | Professional | None | $407.38 | $501.19 | $1,698.24 |
Medica Setting Facility Modifier None Typical Low $295.12 Median $1,023.29 Typical High $2,089.30 | Facility | None | $295.12 | $1,023.29 | $2,089.30 |
Medica Setting Professional Modifier None Typical Low $645.65 Median $1,698.24 Typical High $5,011.87 | Professional | None | $645.65 | $1,698.24 | $5,011.87 |
Midlands Setting Professional Modifier None Typical Low $426.58 Median $426.58 Typical High $1,380.38 | Professional | None | $426.58 | $426.58 | $1,380.38 |
Midlands Setting Facility Modifier None Typical Low $616.60 Median $741.31 Typical High $2,570.40 | Facility | None | $616.60 | $741.31 | $2,570.40 |
Sanford Health Plan Setting Professional Modifier None Typical Low $288.40 Median $776.25 Typical High $1,096.48 | Professional | None | $288.40 | $776.25 | $1,096.48 |
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 $1,778.28 | Professional | None | $218.78 | $512.86 | $1,778.28 |
Wellmark Setting Professional Modifier None Typical Low $331.13 Median $398.11 Typical High $1,479.11 | Professional | None | $331.13 | $398.11 | $1,479.11 |
5 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 $87.10 Median $97.72 Typical High $331.13 | Professional | 52 · Reduced service | $87.10 | $97.72 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $38.90 Typical High $131.83 | Professional | 53 · Discontinued | $35.48 | $38.90 | $131.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $131.83 Median $147.91 Typical High $501.19 | Professional | 54 · Surgery only | $131.83 | $147.91 | $501.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $29.51 Typical High $100.00 | Professional | 55 · Aftercare only | $26.30 | $29.51 | $100.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $19.50 Typical High $66.07 | Professional | 56 · Pre-op care only | $17.38 | $19.50 | $66.07 |
Where South Dakota sits
The same service costs 6.9 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 $7,377MT $1,063
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.