How much rates vary
Facilitymedian $2,570 · 10th to 90th $776 to $7,762Professionalmedian $1,096 · 10th to 90th $575 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 $851.14 Median $4,265.80 Typical High $7,244.36 | Facility | None | $851.14 | $4,265.80 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $478.63 Median $851.14 Typical High $851.14 | Professional | None | $478.63 | $851.14 | $851.14 |
Cigna Setting Facility Modifier None Typical Low $1,096.48 Median $2,238.72 Typical High $2,884.03 | Facility | None | $1,096.48 | $2,238.72 | $2,884.03 |
Cigna Setting Professional Modifier None Typical Low $537.03 Median $1,122.02 Typical High $1,412.54 | Professional | None | $537.03 | $1,122.02 | $1,412.54 |
Hally Health Setting Professional Modifier None Typical Low $467.74 Median $831.76 Typical High $1,698.24 | Professional | None | $467.74 | $831.76 | $1,698.24 |
Medica Setting Facility Modifier None Typical Low $707.95 Median $1,445.44 Typical High $7,943.28 | Facility | None | $707.95 | $1,445.44 | $7,943.28 |
Medica Setting Professional Modifier None Typical Low $616.60 Median $1,122.02 Typical High $3,801.89 | Professional | None | $616.60 | $1,122.02 | $3,801.89 |
Midlands Setting Professional Modifier None Typical Low $1,096.48 Median $1,122.02 Typical High $1,412.54 | Professional | None | $1,096.48 | $1,122.02 | $1,412.54 |
Midlands Setting Facility Modifier None Typical Low $1,148.15 Median $2,238.72 Typical High $2,884.03 | Facility | None | $1,148.15 | $2,238.72 | $2,884.03 |
Midlands Setting Professional Modifier None Typical Low $870.96 Median $1,288.25 Typical High $1,548.82 | Professional | None | $870.96 | $1,288.25 | $1,548.82 |
United Setting Facility Modifier None Typical Low $724.44 Median $3,090.30 Typical High $8,709.64 | Facility | None | $724.44 | $3,090.30 | $8,709.64 |
United Setting Professional Modifier None Typical Low $524.81 Median $758.58 Typical High $1,412.54 | Professional | None | $524.81 | $758.58 | $1,412.54 |
Wellmark Setting Professional Modifier None Typical Low $977.24 Median $977.24 Typical High $1,096.48 | Professional | None | $977.24 | $977.24 | $1,096.48 |
6 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 $239.88 Median $426.58 Typical High $426.58 | Professional | 52 · Reduced service | $239.88 | $426.58 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $169.82 Typical High $169.82 | Professional | 53 · Discontinued | $95.50 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $645.65 Typical High $645.65 | Professional | 54 · Surgery only | $363.08 | $645.65 | $645.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $128.82 Typical High $128.82 | Professional | 55 · Aftercare only | $72.44 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $85.11 Typical High $85.11 | Professional | 56 · Pre-op care only | $47.86 | $85.11 | $85.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $602.56 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $338.84 | $602.56 | $602.56 |
Where Iowa sits
The same service costs 3.9 times more in Colorado than in Delaware. 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 $5,057DE $1,284
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.