How much rates vary
Facilitymedian $347 · 10th to 90th $107 to $1,698Professionalmedian $209 · 10th to 90th $98 to $490
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 $177.83 Median $346.74 Typical High $3,890.45 | Facility | None | $177.83 | $346.74 | $3,890.45 |
Aetna Setting Professional Modifier None Typical Low $63.10 Median $151.36 Typical High $204.17 | Professional | None | $63.10 | $151.36 | $204.17 |
Cigna Setting Facility Modifier None Typical Low $181.97 Median $323.59 Typical High $1,698.24 | Facility | None | $181.97 | $323.59 | $1,698.24 |
Cigna Setting Professional Modifier None Typical Low $169.82 Median $295.12 Typical High $524.81 | Professional | None | $169.82 | $295.12 | $524.81 |
Medica Setting Facility Modifier None Typical Low $107.15 Median $257.04 Typical High $1,659.59 | Facility | None | $107.15 | $257.04 | $1,659.59 |
Medica Setting Professional Modifier None Typical Low $186.21 Median $467.74 Typical High $616.60 | Professional | None | $186.21 | $467.74 | $616.60 |
Midlands Setting Professional Modifier None Typical Low $186.21 Median $186.21 Typical High $398.11 | Professional | None | $186.21 | $186.21 | $398.11 |
Midlands Setting Facility Modifier None Typical Low $181.97 Median $1,621.81 Typical High $1,995.26 | Facility | None | $181.97 | $1,621.81 | $1,995.26 |
Midlands Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $316.23 | Professional | None | $147.91 | $147.91 | $316.23 |
Sanford Health Plan Setting Professional Modifier None Typical Low $107.15 Median $173.78 Typical High $338.84 | Professional | None | $107.15 | $173.78 | $338.84 |
United Setting Facility Modifier None Typical Low $758.58 Median $891.25 Typical High $1,698.24 | Facility | None | $758.58 | $891.25 | $1,698.24 |
United Setting Professional Modifier None Typical Low $93.33 Median $218.78 Typical High $489.78 | Professional | None | $93.33 | $218.78 | $489.78 |
Wellmark Setting Professional Modifier None Typical Low $125.89 Median $151.36 Typical High $436.52 | Professional | None | $125.89 | $151.36 | $436.52 |
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 $31.62 Median $39.81 Typical High $91.20 | Professional | 52 · Reduced service | $31.62 | $39.81 | $91.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.59 Median $15.85 Typical High $37.15 | Professional | 53 · Discontinued | $12.59 | $15.85 | $37.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $46.77 Median $58.88 Typical High $138.04 | Professional | 54 · Surgery only | $46.77 | $58.88 | $138.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.33 Median $11.75 Typical High $27.54 | Professional | 55 · Aftercare only | $9.33 | $11.75 | $27.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.31 Median $7.94 Typical High $18.62 | Professional | 56 · Pre-op care only | $6.31 | $7.94 | $18.62 |
Where South Dakota 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.