How much rates vary
Facilitymedian $759 · 10th to 90th $166 to $1,862Professionalmedian $1,202 · 10th to 90th $195 to $3,388
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 $120.23 Median $1,202.26 Typical High $4,365.16 | Facility | None | $120.23 | $1,202.26 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $97.72 Median $199.53 Typical High $1,202.26 | Professional | None | $97.72 | $199.53 | $1,202.26 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $1,819.70 Typical High $2,290.87 | Facility | None | $1,000.00 | $1,819.70 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $239.88 Median $457.09 Typical High $3,019.95 | Professional | None | $239.88 | $457.09 | $3,019.95 |
Medica Setting Facility Modifier None Typical Low $165.96 Median $537.03 Typical High $1,862.09 | Facility | None | $165.96 | $537.03 | $1,862.09 |
Medica Setting Professional Modifier None Typical Low $1,023.29 Median $2,398.83 Typical High $9,120.11 | Professional | None | $1,023.29 | $2,398.83 | $9,120.11 |
Midlands Setting Professional Modifier None Typical Low $281.84 Median $295.12 Typical High $2,398.83 | Professional | None | $281.84 | $295.12 | $2,398.83 |
Midlands Setting Facility Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $1,202.26 | Facility | None | $1,000.00 | $1,000.00 | $1,202.26 |
Midlands Setting Professional Modifier None Typical Low $251.19 Median $251.19 Typical High $2,398.83 | Professional | None | $251.19 | $251.19 | $2,398.83 |
Sanford Health Plan Setting Professional Modifier None Typical Low $165.96 Median $1,202.26 Typical High $2,344.23 | Professional | None | $165.96 | $1,202.26 | $2,344.23 |
United Setting Facility Modifier None Typical Low $446.68 Median $537.03 Typical High $758.58 | Facility | None | $446.68 | $537.03 | $758.58 |
United Setting Professional Modifier None Typical Low $151.36 Median $389.05 Typical High $3,388.44 | Professional | None | $151.36 | $389.05 | $3,388.44 |
Wellmark Setting Professional Modifier None Typical Low $234.42 Median $269.15 Typical High $3,090.30 | Professional | None | $234.42 | $269.15 | $3,090.30 |
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 $48.98 Median $100.00 Typical High $602.56 | Professional | 52 · Reduced service | $48.98 | $100.00 | $602.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.50 Median $39.81 Typical High $239.88 | Professional | 53 · Discontinued | $19.50 | $39.81 | $239.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $74.13 Median $147.91 Typical High $891.25 | Professional | 54 · Surgery only | $74.13 | $147.91 | $891.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.79 Median $30.20 Typical High $177.83 | Professional | 55 · Aftercare only | $14.79 | $30.20 | $177.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.77 Median $19.95 Typical High $120.23 | Professional | 56 · Pre-op care only | $9.77 | $19.95 | $120.23 |
Where South Dakota sits
The same service costs 5.5 times more in Hawaii than in Maryland. 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
HI $4,440MD $808
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.