How much rates vary
Facilitymedian $4,365 · 10th to 90th $692 to $8,913Professionalmedian $5,129 · 10th to 90th $575 to $13,183
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 $436.52 Median $3,548.13 Typical High $5,011.87 | Facility | None | $436.52 | $3,548.13 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $407.38 Median $1,288.25 Typical High $5,128.61 | Professional | None | $407.38 | $1,288.25 | $5,128.61 |
Cigna Setting Facility Modifier None Typical Low $6,025.60 Median $8,317.64 Typical High $9,772.37 | Facility | None | $6,025.60 | $8,317.64 | $9,772.37 |
Cigna Setting Professional Modifier None Typical Low $933.25 Median $1,174.90 Typical High $13,182.57 | Professional | None | $933.25 | $1,174.90 | $13,182.57 |
Medica Setting Facility Modifier None Typical Low $691.83 Median $4,168.69 Typical High $7,943.28 | Facility | None | $691.83 | $4,168.69 | $7,943.28 |
Medica Setting Professional Modifier None Typical Low $4,265.80 Median $10,000.00 Typical High $14,125.38 | Professional | None | $4,265.80 | $10,000.00 | $14,125.38 |
Midlands Setting Professional Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $10,964.78 | Professional | None | $1,023.29 | $1,023.29 | $10,964.78 |
Midlands Setting Facility Modifier None Typical Low $6,025.60 Median $9,332.54 Typical High $10,964.78 | Facility | None | $6,025.60 | $9,332.54 | $10,964.78 |
Sanford Health Plan Setting Professional Modifier None Typical Low $602.56 Median $6,165.95 Typical High $8,317.64 | Professional | None | $602.56 | $6,165.95 | $8,317.64 |
United Setting Facility Modifier None Typical Low $3,981.07 Median $3,981.07 Typical High $4,786.30 | Facility | None | $3,981.07 | $3,981.07 | $4,786.30 |
United Setting Professional Modifier None Typical Low $524.81 Median $1,202.26 Typical High $14,125.38 | Professional | None | $524.81 | $1,202.26 | $14,125.38 |
Wellmark Setting Professional Modifier None Typical Low $776.25 Median $954.99 Typical High $11,220.18 | Professional | None | $776.25 | $954.99 | $11,220.18 |
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 $204.17 Median $223.87 Typical High $2,570.40 | Professional | 52 · Reduced service | $204.17 | $223.87 | $2,570.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $91.20 Typical High $1,023.29 | Professional | 53 · Discontinued | $81.28 | $91.20 | $1,023.29 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $338.84 Typical High $3,801.89 | Professional | 54 · Surgery only | $302.00 | $338.84 | $3,801.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $67.61 Typical High $776.25 | Professional | 55 · Aftercare only | $61.66 | $67.61 | $776.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $45.71 Typical High $512.86 | Professional | 56 · Pre-op care only | $40.74 | $45.71 | $512.86 |
Where South Dakota sits
The same service costs 4.3 times more in Alabama than in Maine. 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
AL $20,420ME $4,758
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.