How much rates vary
Facilitymedian $1,995 · 10th to 90th $204 to $6,457Professionalmedian $257 · 10th to 90th $126 to $537
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 $151.36 Median $549.54 Typical High $6,309.57 | Facility | None | $151.36 | $549.54 | $6,309.57 |
Aetna Setting Professional Modifier None Typical Low $72.44 Median $165.96 Typical High $275.42 | Professional | None | $72.44 | $165.96 | $275.42 |
Cigna Setting Facility Modifier None Typical Low $1,819.70 Median $2,089.30 Typical High $2,630.27 | Facility | None | $1,819.70 | $2,089.30 | $2,630.27 |
Cigna Setting Professional Modifier None Typical Low $169.82 Median $323.59 Typical High $478.63 | Professional | None | $169.82 | $323.59 | $478.63 |
Hally Health Setting Professional Modifier None Typical Low $93.33 Median $229.09 Typical High $489.78 | Professional | None | $93.33 | $229.09 | $489.78 |
Medica Setting Facility Modifier None Typical Low $199.53 Median $776.25 Typical High $6,165.95 | Facility | None | $199.53 | $776.25 | $6,165.95 |
Medica Setting Professional Modifier None Typical Low $186.21 Median $371.54 Typical High $630.96 | Professional | None | $186.21 | $371.54 | $630.96 |
Midlands Setting Professional Modifier None Typical Low $169.82 Median $371.54 Typical High $478.63 | Professional | None | $169.82 | $371.54 | $478.63 |
Midlands Setting Facility Modifier None Typical Low $1,230.27 Median $2,089.30 Typical High $2,630.27 | Facility | None | $1,230.27 | $2,089.30 | $2,630.27 |
Midlands Setting Professional Modifier None Typical Low $204.17 Median $234.42 Typical High $549.54 | Professional | None | $204.17 | $234.42 | $549.54 |
United Setting Facility Modifier None Typical Low $724.44 Median $3,090.30 Typical High $7,762.47 | Facility | None | $724.44 | $3,090.30 | $7,762.47 |
United Setting Professional Modifier None Typical Low $91.20 Median $199.53 Typical High $467.74 | Professional | None | $91.20 | $199.53 | $467.74 |
Wellmark Setting Professional Modifier None Typical Low $125.89 Median $147.91 Typical High $416.87 | Professional | None | $125.89 | $147.91 | $416.87 |
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 $35.48 Median $67.61 Typical High $138.04 | Professional | 52 · Reduced service | $35.48 | $67.61 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.13 Median $27.54 Typical High $54.95 | Professional | 53 · Discontinued | $14.13 | $27.54 | $54.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $56.23 Median $102.33 Typical High $208.93 | Professional | 54 · Surgery only | $56.23 | $102.33 | $208.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.72 Median $20.42 Typical High $41.69 | Professional | 55 · Aftercare only | $10.72 | $20.42 | $41.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.08 Median $13.49 Typical High $27.54 | Professional | 56 · Pre-op care only | $7.08 | $13.49 | $27.54 |
Where Iowa sits
The same service costs 9.7 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 $4,351MT $447
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.