How much rates vary
Facilitymedian $1,514 · 10th to 90th $204 to $5,129Professionalmedian $708 · 10th to 90th $117 to $1,738
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 $138.04 Median $2,238.72 Typical High $6,760.83 | Facility | None | $138.04 | $2,238.72 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $70.79 Median $489.78 Typical High $912.01 | Professional | None | $70.79 | $489.78 | $912.01 |
Cigna Setting Facility Modifier None Typical Low $1,148.15 Median $1,445.44 Typical High $1,862.09 | Facility | None | $1,148.15 | $1,445.44 | $1,862.09 |
Cigna Setting Professional Modifier None Typical Low $154.88 Median $407.38 Typical High $1,348.96 | Professional | None | $154.88 | $407.38 | $1,348.96 |
Hally Health Setting Professional Modifier None Typical Low $64.57 Median $645.65 Typical High $1,000.00 | Professional | None | $64.57 | $645.65 | $1,000.00 |
Medica Setting Facility Modifier None Typical Low $186.21 Median $1,318.26 Typical High $4,897.79 | Facility | None | $186.21 | $1,318.26 | $4,897.79 |
Medica Setting Professional Modifier None Typical Low $144.54 Median $1,202.26 Typical High $4,265.80 | Professional | None | $144.54 | $1,202.26 | $4,265.80 |
Midlands Setting Professional Modifier None Typical Low $154.88 Median $1,071.52 Typical High $1,380.38 | Professional | None | $154.88 | $1,071.52 | $1,380.38 |
Midlands Setting Facility Modifier None Typical Low $954.99 Median $1,445.44 Typical High $1,862.09 | Facility | None | $954.99 | $1,445.44 | $1,862.09 |
Midlands Setting Professional Modifier None Typical Low $177.83 Median $1,071.52 Typical High $1,698.24 | Professional | None | $177.83 | $1,071.52 | $1,698.24 |
Oscar Health Setting Professional Modifier None Typical Low $67.61 Median $151.36 Typical High $1,122.02 | Professional | None | $67.61 | $151.36 | $1,122.02 |
United Setting Facility Modifier None Typical Low $724.44 Median $2,951.21 Typical High $5,888.44 | Facility | None | $724.44 | $2,951.21 | $5,888.44 |
United Setting Professional Modifier None Typical Low $83.18 Median $478.63 Typical High $1,380.38 | Professional | None | $83.18 | $478.63 | $1,380.38 |
Wellmark Setting Professional Modifier None Typical Low $134.90 Median $154.88 Typical High $1,348.96 | Professional | None | $134.90 | $154.88 | $1,348.96 |
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 $35.48 Median $104.71 Typical High $457.09 | Professional | 52 · Reduced service | $35.48 | $104.71 | $457.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.45 Median $41.69 Typical High $181.97 | Professional | 53 · Discontinued | $14.45 | $41.69 | $181.97 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $53.70 Median $154.88 Typical High $691.83 | Professional | 54 · Surgery only | $53.70 | $154.88 | $691.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.72 Median $30.90 Typical High $138.04 | Professional | 55 · Aftercare only | $10.72 | $30.90 | $138.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.08 Median $20.89 Typical High $91.20 | Professional | 56 · Pre-op care only | $7.08 | $20.89 | $91.20 |
Where Iowa sits
The same service costs 5.6 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 $4,728MT $843
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.