How much rates vary
Facilitymedian $851 · 10th to 90th $282 to $1,445Professionalmedian $468 · 10th to 90th $269 to $955
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 $199.53 Median $3,090.30 Typical High $4,365.16 | Facility | None | $199.53 | $3,090.30 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $269.15 | Professional | None | $165.96 | $165.96 | $269.15 |
Cigna Setting Facility Modifier None Typical Low $281.84 Median $851.14 Typical High $1,122.02 | Facility | None | $281.84 | $851.14 | $1,122.02 |
Cigna Setting Professional Modifier None Typical Low $354.81 Median $467.74 Typical High $954.99 | Professional | None | $354.81 | $467.74 | $954.99 |
Medica Setting Facility Modifier None Typical Low $257.04 Median $457.09 Typical High $1,202.26 | Facility | None | $257.04 | $457.09 | $1,202.26 |
Medica Setting Professional Modifier None Typical Low $302.00 Median $562.34 Typical High $2,137.96 | Professional | None | $302.00 | $562.34 | $2,137.96 |
Midlands Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $954.99 | Professional | None | $467.74 | $467.74 | $954.99 |
Midlands Setting Facility Modifier None Typical Low $851.14 Median $954.99 Typical High $1,202.26 | Facility | None | $851.14 | $954.99 | $1,202.26 |
Midlands Setting Professional Modifier None Typical Low $416.87 Median $416.87 Typical High $416.87 | Professional | None | $416.87 | $416.87 | $416.87 |
Sanford Health Plan Setting Professional Modifier None Typical Low $275.42 Median $354.81 Typical High $588.84 | Professional | None | $275.42 | $354.81 | $588.84 |
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 $229.09 Median $436.52 Typical High $794.33 | Professional | None | $229.09 | $436.52 | $794.33 |
Wellmark Setting Professional Modifier None Typical Low $389.05 Median $457.09 Typical High $457.09 | Professional | None | $389.05 | $457.09 | $457.09 |
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 $83.18 Median $83.18 Typical High $100.00 | Professional | 52 · Reduced service | $83.18 | $83.18 | $100.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.11 Median $33.11 Typical High $39.81 | Professional | 53 · Discontinued | $33.11 | $33.11 | $39.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $125.89 Median $125.89 Typical High $151.36 | Professional | 54 · Surgery only | $125.89 | $125.89 | $151.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.12 Median $25.12 Typical High $30.20 | Professional | 55 · Aftercare only | $25.12 | $25.12 | $30.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $16.60 Typical High $19.95 | Professional | 56 · Pre-op care only | $16.60 | $16.60 | $19.95 |
Where South Dakota sits
The same service costs 6.8 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 $4,179MT $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.