How much rates vary
Facilitymedian $1,738 · 10th to 90th $447 to $5,495Professionalmedian $389 · 10th to 90th $214 to $631
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 $602.56 Median $3,548.13 Typical High $6,760.83 | Facility | None | $602.56 | $3,548.13 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $169.82 Median $302.00 Typical High $302.00 | Professional | None | $169.82 | $302.00 | $302.00 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $1,412.54 Typical High $1,737.80 | Facility | None | $954.99 | $1,412.54 | $1,737.80 |
Cigna Setting Professional Modifier None Typical Low $223.87 Median $398.11 Typical High $512.86 | Professional | None | $223.87 | $398.11 | $512.86 |
Hally Health Setting Professional Modifier None Typical Low $165.96 Median $309.03 Typical High $660.69 | Professional | None | $165.96 | $309.03 | $660.69 |
Medica Setting Facility Modifier None Typical Low $323.59 Median $1,174.90 Typical High $5,128.61 | Facility | None | $323.59 | $1,174.90 | $5,128.61 |
Medica Setting Professional Modifier None Typical Low $229.09 Median $389.05 Typical High $2,454.71 | Professional | None | $229.09 | $389.05 | $2,454.71 |
Midlands Setting Professional Modifier None Typical Low $398.11 Median $398.11 Typical High $489.78 | Professional | None | $398.11 | $398.11 | $489.78 |
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 $338.84 Median $457.09 Typical High $549.54 | Professional | None | $338.84 | $457.09 | $549.54 |
Oscar Health Setting Professional Modifier None Typical Low $162.18 Median $302.00 Typical High $380.19 | Professional | None | $162.18 | $302.00 | $380.19 |
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 $190.55 Median $281.84 Typical High $512.86 | Professional | None | $190.55 | $281.84 | $512.86 |
Wellmark Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $398.11 | Professional | None | $354.81 | $354.81 | $398.11 |
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 $85.11 Median $151.36 Typical High $151.36 | Professional | 52 · Reduced service | $85.11 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $60.26 Typical High $60.26 | Professional | 53 · Discontinued | $33.88 | $60.26 | $60.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $125.89 Median $229.09 Typical High $229.09 | Professional | 54 · Surgery only | $125.89 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.12 Median $45.71 Typical High $45.71 | Professional | 55 · Aftercare only | $25.12 | $45.71 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $30.20 Typical High $30.20 | Professional | 56 · Pre-op care only | $16.98 | $30.20 | $30.20 |
Where Iowa sits
The same service costs 7.3 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 $4,136MT $564
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.