How much rates vary
Facilitymedian $5,012 · 10th to 90th $676 to $14,791Professionalmedian $603 · 10th to 90th $331 to $1,047
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 $4,265.80 Typical High $7,244.36 | Facility | None | $602.56 | $4,265.80 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $275.42 Median $467.74 Typical High $467.74 | Professional | None | $275.42 | $467.74 | $467.74 |
Cigna Setting Facility Modifier None Typical Low $1,096.48 Median $3,715.35 Typical High $6,606.93 | Facility | None | $1,096.48 | $3,715.35 | $6,606.93 |
Cigna Setting Professional Modifier None Typical Low $354.81 Median $616.60 Typical High $776.25 | Professional | None | $354.81 | $616.60 | $776.25 |
Hally Health Setting Professional Modifier None Typical Low $263.03 Median $489.78 Typical High $1,047.13 | Professional | None | $263.03 | $489.78 | $1,047.13 |
Medica Setting Facility Modifier None Typical Low $549.54 Median $3,235.94 Typical High $15,135.61 | Facility | None | $549.54 | $3,235.94 | $15,135.61 |
Medica Setting Professional Modifier None Typical Low $363.08 Median $602.56 Typical High $2,089.30 | Professional | None | $363.08 | $602.56 | $2,089.30 |
Midlands Setting Professional Modifier None Typical Low $616.60 Median $616.60 Typical High $758.58 | Professional | None | $616.60 | $616.60 | $758.58 |
Midlands Setting Facility Modifier None Typical Low $1,737.80 Median $3,715.35 Typical High $6,606.93 | Facility | None | $1,737.80 | $3,715.35 | $6,606.93 |
Midlands Setting Professional Modifier None Typical Low $602.56 Median $691.83 Typical High $831.76 | Professional | None | $602.56 | $691.83 | $831.76 |
United Setting Facility Modifier None Typical Low $1,819.70 Median $6,309.57 Typical High $16,982.44 | Facility | None | $1,819.70 | $6,309.57 | $16,982.44 |
United Setting Professional Modifier None Typical Low $295.12 Median $446.68 Typical High $794.33 | Professional | None | $295.12 | $446.68 | $794.33 |
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 $128.82 Median $234.42 Typical High $234.42 | Professional | 52 · Reduced service | $128.82 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $51.29 Median $93.33 Typical High $93.33 | Professional | 53 · Discontinued | $51.29 | $93.33 | $93.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $194.98 Median $346.74 Typical High $346.74 | Professional | 54 · Surgery only | $194.98 | $346.74 | $346.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $69.18 Typical High $69.18 | Professional | 55 · Aftercare only | $38.90 | $69.18 | $69.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $46.77 Typical High $46.77 | Professional | 56 · Pre-op care only | $25.70 | $46.77 | $46.77 |
Where Iowa sits
The same service costs 10.4 times more in Wyoming 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
WY $8,979MT $863
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.