How much rates vary
Facilitymedian $4,571 · 10th to 90th $1,096 to $13,183Professionalmedian $1,380 · 10th to 90th $692 to $1,995
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 $1,047.13 Median $4,265.80 Typical High $7,244.36 | Facility | None | $1,047.13 | $4,265.80 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $588.84 Median $1,047.13 Typical High $1,047.13 | Professional | None | $588.84 | $1,047.13 | $1,047.13 |
Cigna Setting Facility Modifier None Typical Low $4,570.88 Median $5,754.40 Typical High $6,309.57 | Facility | None | $4,570.88 | $5,754.40 | $6,309.57 |
Cigna Setting Professional Modifier None Typical Low $676.08 Median $1,445.44 Typical High $1,737.80 | Professional | None | $676.08 | $1,445.44 | $1,737.80 |
Hally Health Setting Professional Modifier None Typical Low $588.84 Median $933.25 Typical High $2,041.74 | Professional | None | $588.84 | $933.25 | $2,041.74 |
Medica Setting Facility Modifier None Typical Low $1,096.48 Median $1,778.28 Typical High $13,182.57 | Facility | None | $1,096.48 | $1,778.28 | $13,182.57 |
Medica Setting Professional Modifier None Typical Low $741.31 Median $1,412.54 Typical High $4,677.35 | Professional | None | $741.31 | $1,412.54 | $4,677.35 |
Midlands Setting Professional Modifier None Typical Low $1,445.44 Median $1,445.44 Typical High $1,737.80 | Professional | None | $1,445.44 | $1,445.44 | $1,737.80 |
Midlands Setting Facility Modifier None Typical Low $4,570.88 Median $5,754.40 Typical High $6,309.57 | Facility | None | $4,570.88 | $5,754.40 | $6,309.57 |
Midlands Setting Professional Modifier None Typical Low $1,174.90 Median $1,584.89 Typical High $1,949.84 | Professional | None | $1,174.90 | $1,584.89 | $1,949.84 |
United Setting Facility Modifier None Typical Low $1,584.89 Median $5,011.87 Typical High $15,848.93 | Facility | None | $1,584.89 | $5,011.87 | $15,848.93 |
United Setting Professional Modifier None Typical Low $660.69 Median $912.01 Typical High $1,737.80 | Professional | None | $660.69 | $912.01 | $1,737.80 |
Wellmark Setting Professional Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $1,479.11 | Professional | None | $1,348.96 | $1,348.96 | $1,479.11 |
6 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 $288.40 Median $524.81 Typical High $524.81 | Professional | 52 · Reduced service | $288.40 | $524.81 | $524.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $117.49 Median $208.93 Typical High $208.93 | Professional | 53 · Discontinued | $117.49 | $208.93 | $208.93 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $436.52 Median $794.33 Typical High $794.33 | Professional | 54 · Surgery only | $436.52 | $794.33 | $794.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $87.10 Median $158.49 Typical High $158.49 | Professional | 55 · Aftercare only | $87.10 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $58.88 Median $104.71 Typical High $104.71 | Professional | 56 · Pre-op care only | $58.88 | $104.71 | $104.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $407.38 Median $741.31 Typical High $741.31 | Professional | 78 · Unplanned return to OR | $407.38 | $741.31 | $741.31 |
Where Iowa sits
The same service costs 5.4 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 $11,084MT $2,070
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.