How much rates vary
Facilitymedian $1,380 · 10th to 90th $501 to $5,012Professionalmedian $550 · 10th to 90th $309 to $1,413
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 $389.05 Median $1,584.89 Typical High $6,309.57 | Facility | None | $389.05 | $1,584.89 | $6,309.57 |
Aetna Setting Professional Modifier None Typical Low $194.98 Median $446.68 Typical High $954.99 | Professional | None | $194.98 | $446.68 | $954.99 |
Cigna Setting Facility Modifier None Typical Low $891.25 Median $1,412.54 Typical High $1,737.80 | Facility | None | $891.25 | $1,412.54 | $1,737.80 |
Cigna Setting Professional Modifier None Typical Low $380.19 Median $549.54 Typical High $1,148.15 | Professional | None | $380.19 | $549.54 | $1,148.15 |
Hally Health Setting Professional Modifier None Typical Low $177.83 Median $426.58 Typical High $1,023.29 | Professional | None | $177.83 | $426.58 | $1,023.29 |
Medica Setting Facility Modifier None Typical Low $398.11 Median $1,288.25 Typical High $5,011.87 | Facility | None | $398.11 | $1,288.25 | $5,011.87 |
Medica Setting Professional Modifier None Typical Low $323.59 Median $1,000.00 Typical High $3,630.78 | Professional | None | $323.59 | $1,000.00 | $3,630.78 |
Midlands Setting Professional Modifier None Typical Low $380.19 Median $870.96 Typical High $1,230.27 | Professional | None | $380.19 | $870.96 | $1,230.27 |
Midlands Setting Facility Modifier None Typical Low $954.99 Median $1,380.38 Typical High $1,737.80 | Facility | None | $954.99 | $1,380.38 | $1,737.80 |
Midlands Setting Professional Modifier None Typical Low $489.78 Median $851.14 Typical High $1,380.38 | Professional | None | $489.78 | $851.14 | $1,380.38 |
Oscar Health Setting Facility Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $1,122.02 | Facility | None | $1,122.02 | $1,122.02 | $1,122.02 |
Oscar Health Setting Professional Modifier None Typical Low $190.55 Median $426.58 Typical High $1,122.02 | Professional | None | $190.55 | $426.58 | $1,122.02 |
United Setting Facility Modifier None Typical Low $724.44 Median $2,951.21 Typical High $5,888.44 | Facility | None | $724.44 | $2,951.21 | $5,888.44 |
United Setting Professional Modifier None Typical Low $223.87 Median $489.78 Typical High $1,122.02 | Professional | None | $223.87 | $489.78 | $1,122.02 |
Wellmark Setting Professional Modifier None Typical Low $380.19 Median $446.68 Typical High $1,348.96 | Professional | None | $380.19 | $446.68 | $1,348.96 |
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 $100.00 Median $162.18 Typical High $398.11 | Professional | 52 · Reduced service | $100.00 | $162.18 | $398.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $39.81 Median $64.57 Typical High $158.49 | Professional | 53 · Discontinued | $39.81 | $64.57 | $158.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $151.36 Median $245.47 Typical High $602.56 | Professional | 54 · Surgery only | $151.36 | $245.47 | $602.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $48.98 Typical High $120.23 | Professional | 55 · Aftercare only | $30.20 | $48.98 | $120.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $32.36 Typical High $79.43 | Professional | 56 · Pre-op care only | $19.95 | $32.36 | $79.43 |
Where Iowa sits
The same service costs 4.1 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 $4,142MT $1,002
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.