How much rates vary
Facilitymedian $1,549 · 10th to 90th $603 to $5,012Professionalmedian $479 · 10th to 90th $263 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 $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 $239.88 Median $416.87 Typical High $416.87 | Professional | None | $239.88 | $416.87 | $416.87 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $1,071.52 Typical High $1,548.82 | Facility | None | $707.95 | $1,071.52 | $1,548.82 |
Cigna Setting Professional Modifier None Typical Low $263.03 Median $588.84 Typical High $707.95 | Professional | None | $263.03 | $588.84 | $707.95 |
Hally Health Setting Professional Modifier None Typical Low $229.09 Median $338.84 Typical High $1,318.26 | Professional | None | $229.09 | $338.84 | $1,318.26 |
Medica Setting Facility Modifier None Typical Low $489.78 Median $1,148.15 Typical High $3,890.45 | Facility | None | $489.78 | $1,148.15 | $3,890.45 |
Medica Setting Professional Modifier None Typical Low $295.12 Median $588.84 Typical High $1,862.09 | Professional | None | $295.12 | $588.84 | $1,862.09 |
Midlands Setting Professional Modifier None Typical Low $549.54 Median $630.96 Typical High $707.95 | Professional | None | $549.54 | $630.96 | $707.95 |
Midlands Setting Facility Modifier None Typical Low $707.95 Median $1,071.52 Typical High $1,548.82 | Facility | None | $707.95 | $1,071.52 | $1,548.82 |
Midlands Setting Professional Modifier None Typical Low $512.86 Median $630.96 Typical High $707.95 | Professional | None | $512.86 | $630.96 | $707.95 |
Oscar Health Setting Professional Modifier None Typical Low $223.87 Median $416.87 Typical High $524.81 | Professional | None | $223.87 | $416.87 | $524.81 |
United Setting Facility Modifier None Typical Low $724.44 Median $2,754.23 Typical High $5,495.41 | Facility | None | $724.44 | $2,754.23 | $5,495.41 |
United Setting Professional Modifier None Typical Low $269.15 Median $389.05 Typical High $707.95 | Professional | None | $269.15 | $389.05 | $707.95 |
Wellmark Setting Professional Modifier None Typical Low $478.63 Median $478.63 Typical High $537.03 | Professional | None | $478.63 | $478.63 | $537.03 |
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 $117.49 Median $208.93 Typical High $208.93 | Professional | 52 · Reduced service | $117.49 | $208.93 | $208.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $46.77 Median $83.18 Typical High $83.18 | Professional | 53 · Discontinued | $46.77 | $83.18 | $83.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $173.78 Median $309.03 Typical High $309.03 | Professional | 54 · Surgery only | $173.78 | $309.03 | $309.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $61.66 Typical High $61.66 | Professional | 55 · Aftercare only | $35.48 | $61.66 | $61.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.44 Median $41.69 Typical High $41.69 | Professional | 56 · Pre-op care only | $23.44 | $41.69 | $41.69 |
Where Iowa sits
The same service costs 5.6 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 $4,320MT $769
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.