How much rates vary
Facilitymedian $759 · 10th to 90th $182 to $1,202Professionalmedian $380 · 10th to 90th $186 to $1,072
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 $128.82 Median $363.08 Typical High $4,365.16 | Facility | None | $128.82 | $363.08 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $107.15 Median $213.80 Typical High $478.63 | Professional | None | $107.15 | $213.80 | $478.63 |
Cigna Setting Facility Modifier None Typical Low $562.34 Median $851.14 Typical High $1,122.02 | Facility | None | $562.34 | $851.14 | $1,122.02 |
Cigna Setting Professional Modifier None Typical Low $257.04 Median $407.38 Typical High $1,000.00 | Professional | None | $257.04 | $407.38 | $1,000.00 |
Medica Setting Facility Modifier None Typical Low $181.97 Median $562.34 Typical High $1,202.26 | Facility | None | $181.97 | $562.34 | $1,202.26 |
Medica Setting Professional Modifier None Typical Low $302.00 Median $758.58 Typical High $2,818.38 | Professional | None | $302.00 | $758.58 | $2,818.38 |
Midlands Setting Professional Modifier None Typical Low $302.00 Median $323.59 Typical High $758.58 | Professional | None | $302.00 | $323.59 | $758.58 |
Midlands Setting Facility Modifier None Typical Low $645.65 Median $851.14 Typical High $1,202.26 | Facility | None | $645.65 | $851.14 | $1,202.26 |
Midlands Setting Professional Modifier None Typical Low $169.82 Median $169.82 Typical High $457.09 | Professional | None | $169.82 | $169.82 | $457.09 |
Sanford Health Plan Setting Professional Modifier None Typical Low $181.97 Median $389.05 Typical High $691.83 | Professional | None | $181.97 | $389.05 | $691.83 |
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 $162.18 Median $354.81 Typical High $1,000.00 | Professional | None | $162.18 | $354.81 | $1,000.00 |
Wellmark Setting Professional Modifier None Typical Low $257.04 Median $302.00 Typical High $1,071.52 | Professional | None | $257.04 | $302.00 | $1,071.52 |
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 $53.70 Median $107.15 Typical High $186.21 | Professional | 52 · Reduced service | $53.70 | $107.15 | $186.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $43.65 Typical High $74.13 | Professional | 53 · Discontinued | $21.38 | $43.65 | $74.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $81.28 Median $162.18 Typical High $275.42 | Professional | 54 · Surgery only | $81.28 | $162.18 | $275.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $32.36 Typical High $54.95 | Professional | 55 · Aftercare only | $16.22 | $32.36 | $54.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $21.38 Typical High $37.15 | Professional | 56 · Pre-op care only | $10.72 | $21.38 | $37.15 |
Where South Dakota sits
The same service costs 5.7 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 $4,090MT $722
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.