How much rates vary
Facilitymedian $417 · 10th to 90th $107 to $1,202Professionalmedian $263 · 10th to 90th $123 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 $74.13 Median $263.03 Typical High $4,365.16 | Facility | None | $74.13 | $263.03 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $63.10 Median $190.55 Typical High $269.15 | Professional | None | $63.10 | $190.55 | $269.15 |
Cigna Setting Facility Modifier None Typical Low $229.09 Median $354.81 Typical High $512.86 | Facility | None | $229.09 | $354.81 | $512.86 |
Cigna Setting Professional Modifier None Typical Low $151.36 Median $302.00 Typical High $741.31 | Professional | None | $151.36 | $302.00 | $741.31 |
Medica Setting Facility Modifier None Typical Low $107.15 Median $416.87 Typical High $1,202.26 | Facility | None | $107.15 | $416.87 | $1,202.26 |
Medica Setting Professional Modifier None Typical Low $199.53 Median $549.54 Typical High $2,041.74 | Professional | None | $199.53 | $549.54 | $2,041.74 |
Midlands Setting Professional Modifier None Typical Low $173.78 Median $190.55 Typical High $549.54 | Professional | None | $173.78 | $190.55 | $549.54 |
Midlands Setting Facility Modifier None Typical Low $229.09 Median $295.12 Typical High $426.58 | Facility | None | $229.09 | $295.12 | $426.58 |
Midlands Setting Professional Modifier None Typical Low $154.88 Median $154.88 Typical High $524.81 | Professional | None | $154.88 | $154.88 | $524.81 |
Sanford Health Plan Setting Professional Modifier None Typical Low $102.33 Median $275.42 Typical High $501.19 | Professional | None | $102.33 | $275.42 | $501.19 |
United Setting Facility Modifier None Typical Low $758.58 Median $891.25 Typical High $1,698.24 | Facility | None | $758.58 | $891.25 | $1,698.24 |
United Setting Professional Modifier None Typical Low $89.13 Median $208.93 Typical High $724.44 | Professional | None | $89.13 | $208.93 | $724.44 |
Wellmark Setting Professional Modifier None Typical Low $158.49 Median $181.97 Typical High $776.25 | Professional | None | $158.49 | $181.97 | $776.25 |
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 $31.62 Median $63.10 Typical High $134.90 | Professional | 52 · Reduced service | $31.62 | $63.10 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.59 Median $25.12 Typical High $53.70 | Professional | 53 · Discontinued | $12.59 | $25.12 | $53.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $47.86 Median $93.33 Typical High $199.53 | Professional | 54 · Surgery only | $47.86 | $93.33 | $199.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.55 Median $19.05 Typical High $39.81 | Professional | 55 · Aftercare only | $9.55 | $19.05 | $39.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.31 Median $12.59 Typical High $26.92 | Professional | 56 · Pre-op care only | $6.31 | $12.59 | $26.92 |
Where South Dakota 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.