How much rates vary
Facilitymedian $851 · 10th to 90th $98 to $1,413Professionalmedian $661 · 10th to 90th $117 to $1,698
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 $72.44 Median $616.60 Typical High $4,365.16 | Facility | None | $72.44 | $616.60 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $57.54 Median $117.49 Typical High $616.60 | Professional | None | $57.54 | $117.49 | $616.60 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $1,122.02 Typical High $1,122.02 | Facility | None | $851.14 | $1,122.02 | $1,122.02 |
Cigna Setting Professional Modifier None Typical Low $138.04 Median $323.59 Typical High $1,621.81 | Professional | None | $138.04 | $323.59 | $1,621.81 |
Medica Setting Facility Modifier None Typical Low $97.72 Median $758.58 Typical High $1,202.26 | Facility | None | $97.72 | $758.58 | $1,202.26 |
Medica Setting Professional Modifier None Typical Low $524.81 Median $1,288.25 Typical High $4,265.80 | Professional | None | $524.81 | $1,288.25 | $4,265.80 |
Midlands Setting Professional Modifier None Typical Low $169.82 Median $177.83 Typical High $1,288.25 | Professional | None | $169.82 | $177.83 | $1,288.25 |
Midlands Setting Facility Modifier None Typical Low $954.99 Median $1,122.02 Typical High $1,445.44 | Facility | None | $954.99 | $1,122.02 | $1,445.44 |
Midlands Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $1,230.27 | Professional | None | $147.91 | $147.91 | $1,230.27 |
Sanford Health Plan Setting Professional Modifier None Typical Low $100.00 Median $676.08 Typical High $1,023.29 | Professional | None | $100.00 | $676.08 | $1,023.29 |
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 $223.87 Typical High $1,698.24 | Professional | None | $89.13 | $223.87 | $1,698.24 |
Wellmark Setting Professional Modifier None Typical Low $134.90 Median $154.88 Typical High $1,412.54 | Professional | None | $134.90 | $154.88 | $1,412.54 |
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 $28.84 Median $58.88 Typical High $275.42 | Professional | 52 · Reduced service | $28.84 | $58.88 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.75 Median $23.44 Typical High $109.65 | Professional | 53 · Discontinued | $11.75 | $23.44 | $109.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $43.65 Median $87.10 Typical High $416.87 | Professional | 54 · Surgery only | $43.65 | $87.10 | $416.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.71 Median $17.38 Typical High $83.18 | Professional | 55 · Aftercare only | $8.71 | $17.38 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.75 Median $11.75 Typical High $54.95 | Professional | 56 · Pre-op care only | $5.75 | $11.75 | $54.95 |
Where South Dakota 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.