How much rates vary
Facilitymedian $1,862 · 10th to 90th $646 to $5,754Professionalmedian $813 · 10th to 90th $417 to $1,230
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 $616.60 Median $3,548.13 Typical High $6,760.83 | Facility | None | $616.60 | $3,548.13 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $354.81 Median $616.60 Typical High $891.25 | Professional | None | $354.81 | $616.60 | $891.25 |
Cigna Setting Facility Modifier None Typical Low $1,445.44 Median $1,737.80 Typical High $2,818.38 | Facility | None | $1,445.44 | $1,737.80 | $2,818.38 |
Cigna Setting Professional Modifier None Typical Low $489.78 Median $812.83 Typical High $1,023.29 | Professional | None | $489.78 | $812.83 | $1,023.29 |
Hally Health Setting Professional Modifier None Typical Low $346.74 Median $489.78 Typical High $1,318.26 | Professional | None | $346.74 | $489.78 | $1,318.26 |
Medica Setting Facility Modifier None Typical Low $489.78 Median $1,174.90 Typical High $5,495.41 | Facility | None | $489.78 | $1,174.90 | $5,495.41 |
Medica Setting Professional Modifier None Typical Low $436.52 Median $812.83 Typical High $2,754.23 | Professional | None | $436.52 | $812.83 | $2,754.23 |
Midlands Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $1,023.29 | Professional | None | $812.83 | $812.83 | $1,023.29 |
Midlands Setting Facility Modifier None Typical Low $1,445.44 Median $1,737.80 Typical High $2,754.23 | Facility | None | $1,445.44 | $1,737.80 | $2,754.23 |
Midlands Setting Professional Modifier None Typical Low $676.08 Median $933.25 Typical High $1,148.15 | Professional | None | $676.08 | $933.25 | $1,148.15 |
Oscar Health Setting Professional Modifier None Typical Low $338.84 Median $630.96 Typical High $776.25 | Professional | None | $338.84 | $630.96 | $776.25 |
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 $398.11 Median $588.84 Typical High $1,047.13 | Professional | None | $398.11 | $588.84 | $1,047.13 |
Wellmark Setting Professional Modifier None Typical Low $724.44 Median $724.44 Typical High $812.83 | Professional | None | $724.44 | $724.44 | $812.83 |
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 $173.78 Median $309.03 Typical High $309.03 | Professional | 52 · Reduced service | $173.78 | $309.03 | $309.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $125.89 Typical High $125.89 | Professional | 53 · Discontinued | $69.18 | $125.89 | $125.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $467.74 Typical High $467.74 | Professional | 54 · Surgery only | $263.03 | $467.74 | $467.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $93.33 Typical High $93.33 | Professional | 55 · Aftercare only | $52.48 | $93.33 | $93.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $61.66 Typical High $61.66 | Professional | 56 · Pre-op care only | $34.67 | $61.66 | $61.66 |
Where Iowa sits
The same service costs 5.0 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 $5,749MT $1,151
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.