How much rates vary
Facilitymedian $776 · 10th to 90th $224 to $5,012Professionalmedian $288 · 10th to 90th $107 to $776
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 $446.68 Median $2,630.27 Typical High $6,760.83 | Facility | None | $446.68 | $2,630.27 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $75.86 Median $208.93 Typical High $446.68 | Professional | None | $75.86 | $208.93 | $446.68 |
Cigna Setting Facility Modifier None Typical Low $302.00 Median $436.52 Typical High $562.34 | Facility | None | $302.00 | $436.52 | $562.34 |
Cigna Setting Professional Modifier None Typical Low $169.82 Median $245.47 Typical High $645.65 | Professional | None | $169.82 | $245.47 | $645.65 |
Hally Health Setting Professional Modifier None Typical Low $69.18 Median $275.42 Typical High $478.63 | Professional | None | $69.18 | $275.42 | $478.63 |
Medica Setting Facility Modifier None Typical Low $208.93 Median $616.60 Typical High $3,801.89 | Facility | None | $208.93 | $616.60 | $3,801.89 |
Medica Setting Professional Modifier None Typical Low $114.82 Median $575.44 Typical High $2,041.74 | Professional | None | $114.82 | $575.44 | $2,041.74 |
Midlands Setting Professional Modifier None Typical Low $169.82 Median $512.86 Typical High $707.95 | Professional | None | $169.82 | $512.86 | $707.95 |
Midlands Setting Facility Modifier None Typical Low $295.12 Median $426.58 Typical High $562.34 | Facility | None | $295.12 | $426.58 | $562.34 |
Midlands Setting Professional Modifier None Typical Low $190.55 Median $436.52 Typical High $776.25 | Professional | None | $190.55 | $436.52 | $776.25 |
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 $83.18 Median $234.42 Typical High $602.56 | Professional | None | $83.18 | $234.42 | $602.56 |
Wellmark Setting Professional Modifier None Typical Low $158.49 Median $181.97 Typical High $758.58 | Professional | None | $158.49 | $181.97 | $758.58 |
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 $38.02 Median $95.50 Typical High $223.87 | Professional | 52 · Reduced service | $38.02 | $95.50 | $223.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.49 Median $38.90 Typical High $89.13 | Professional | 53 · Discontinued | $15.49 | $38.90 | $89.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $57.54 Median $144.54 Typical High $338.84 | Professional | 54 · Surgery only | $57.54 | $144.54 | $338.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.48 Median $28.84 Typical High $67.61 | Professional | 55 · Aftercare only | $11.48 | $28.84 | $67.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.76 Median $19.50 Typical High $44.67 | Professional | 56 · Pre-op care only | $7.76 | $19.50 | $44.67 |
Where Iowa sits
The same service costs 9.0 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 $4,579MT $507
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.