How much rates vary
Facilitymedian $813 · 10th to 90th $407 to $2,239Professionalmedian $309 · 10th to 90th $186 to $447
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 $269.15 Median $1,698.24 Typical High $2,818.38 | Facility | None | $269.15 | $1,698.24 | $2,818.38 |
Aetna Setting Professional Modifier None Typical Low $218.78 Median $269.15 Typical High $269.15 | Professional | None | $218.78 | $269.15 | $269.15 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $812.83 Typical High $1,023.29 | Facility | None | $588.84 | $812.83 | $1,023.29 |
Cigna Setting Professional Modifier None Typical Low $186.21 Median $309.03 Typical High $407.38 | Professional | None | $186.21 | $309.03 | $407.38 |
United Setting Facility Modifier None Typical Low $407.38 Median $588.84 Typical High $2,187.76 | Facility | None | $407.38 | $588.84 | $2,187.76 |
United Setting Professional Modifier None Typical Low $181.97 Median $338.84 Typical High $478.63 | Professional | None | $181.97 | $338.84 | $478.63 |
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 $91.20 Median $134.90 Typical High $134.90 | Professional | 52 · Reduced service | $91.20 | $134.90 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $54.95 Typical High $54.95 | Professional | 53 · Discontinued | $37.15 | $54.95 | $54.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $204.17 Typical High $204.17 | Professional | 54 · Surgery only | $138.04 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $40.74 Typical High $40.74 | Professional | 55 · Aftercare only | $27.54 | $40.74 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $26.92 Typical High $26.92 | Professional | 56 · Pre-op care only | $18.62 | $26.92 | $26.92 |
Where Arkansas sits
The same service costs 7.6 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 $4,681MT $618
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.