How much rates vary
Facilitymedian $3,162 · 10th to 90th $617 to $11,482Professionalmedian $617 · 10th to 90th $309 to $933
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 $275.42 Median $478.63 Typical High $478.63 | Professional | None | $275.42 | $478.63 | $478.63 |
Cigna Setting Facility Modifier None Typical Low $4,168.69 Median $7,413.10 Typical High $10,471.29 | Facility | None | $4,168.69 | $7,413.10 | $10,471.29 |
Cigna Setting Professional Modifier None Typical Low $354.81 Median $630.96 Typical High $812.83 | Professional | None | $354.81 | $630.96 | $812.83 |
Hally Health Setting Professional Modifier None Typical Low $263.03 Median $389.05 Typical High $1,412.54 | Professional | None | $263.03 | $389.05 | $1,412.54 |
Medica Setting Facility Modifier None Typical Low $416.87 Median $1,174.90 Typical High $12,589.25 | Facility | None | $416.87 | $1,174.90 | $12,589.25 |
Medica Setting Professional Modifier None Typical Low $338.84 Median $645.65 Typical High $2,137.96 | Professional | None | $338.84 | $645.65 | $2,137.96 |
Midlands Setting Professional Modifier None Typical Low $630.96 Median $630.96 Typical High $812.83 | Professional | None | $630.96 | $630.96 | $812.83 |
Midlands Setting Facility Modifier None Typical Low $4,168.69 Median $7,413.10 Typical High $10,471.29 | Facility | None | $4,168.69 | $7,413.10 | $10,471.29 |
Midlands Setting Professional Modifier None Typical Low $588.84 Median $724.44 Typical High $891.25 | Professional | None | $588.84 | $724.44 | $891.25 |
Oscar Health Setting Professional Modifier None Typical Low $257.04 Median $478.63 Typical High $602.56 | Professional | None | $257.04 | $478.63 | $602.56 |
United Setting Facility Modifier None Typical Low $724.44 Median $3,090.30 Typical High $15,848.93 | Facility | None | $724.44 | $3,090.30 | $15,848.93 |
United Setting Professional Modifier None Typical Low $309.03 Median $467.74 Typical High $870.96 | Professional | None | $309.03 | $467.74 | $870.96 |
Wellmark Setting Professional Modifier None Typical Low $562.34 Median $562.34 Typical High $616.60 | Professional | None | $562.34 | $562.34 | $616.60 |
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 $134.90 Median $239.88 Typical High $239.88 | Professional | 52 · Reduced service | $134.90 | $239.88 | $239.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $53.70 Median $95.50 Typical High $95.50 | Professional | 53 · Discontinued | $53.70 | $95.50 | $95.50 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $199.53 Median $363.08 Typical High $363.08 | Professional | 54 · Surgery only | $199.53 | $363.08 | $363.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $39.81 Median $72.44 Typical High $72.44 | Professional | 55 · Aftercare only | $39.81 | $72.44 | $72.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $47.86 Typical High $47.86 | Professional | 56 · Pre-op care only | $26.92 | $47.86 | $47.86 |
Where Iowa sits
The same service costs 7.8 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 $7,005MT $893
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.