How much rates vary
Facilitymedian $1,514 · 10th to 90th $501 to $2,692Professionalmedian $832 · 10th to 90th $427 to $1,202
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 $354.81 Median $426.58 Typical High $4,365.16 | Facility | None | $354.81 | $426.58 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $295.12 Median $354.81 Typical High $426.58 | Professional | None | $295.12 | $354.81 | $426.58 |
Cigna Setting Facility Modifier None Typical Low $616.60 Median $1,778.28 Typical High $3,388.44 | Facility | None | $616.60 | $1,778.28 | $3,388.44 |
Cigna Setting Professional Modifier None Typical Low $724.44 Median $1,000.00 Typical High $1,230.27 | Professional | None | $724.44 | $1,000.00 | $1,230.27 |
Medica Setting Facility Modifier None Typical Low $501.19 Median $616.60 Typical High $1,698.24 | Facility | None | $501.19 | $616.60 | $1,698.24 |
Medica Setting Professional Modifier None Typical Low $467.74 Median $1,148.15 Typical High $6,165.95 | Professional | None | $467.74 | $1,148.15 | $6,165.95 |
Midlands Setting Professional Modifier None Typical Low $831.76 Median $831.76 Typical High $1,000.00 | Professional | None | $831.76 | $831.76 | $1,000.00 |
Midlands Setting Facility Modifier None Typical Low $645.65 Median $1,778.28 Typical High $3,715.35 | Facility | None | $645.65 | $1,778.28 | $3,715.35 |
Midlands Setting Professional Modifier None Typical Low $724.44 Median $724.44 Typical High $870.96 | Professional | None | $724.44 | $724.44 | $870.96 |
Sanford Health Plan Setting Professional Modifier None Typical Low $501.19 Median $645.65 Typical High $831.76 | Professional | None | $501.19 | $645.65 | $831.76 |
United Setting Facility Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $1,819.70 | Facility | None | $1,513.56 | $1,513.56 | $1,819.70 |
United Setting Professional Modifier None Typical Low $389.05 Median $933.25 Typical High $1,202.26 | Professional | None | $389.05 | $933.25 | $1,202.26 |
Wellmark Setting Professional Modifier None Typical Low $616.60 Median $758.58 Typical High $1,096.48 | Professional | None | $616.60 | $758.58 | $1,096.48 |
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 $147.91 Median $177.83 Typical High $213.80 | Professional | 52 · Reduced service | $147.91 | $177.83 | $213.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $58.88 Median $70.79 Typical High $85.11 | Professional | 53 · Discontinued | $58.88 | $70.79 | $85.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $223.87 Median $263.03 Typical High $323.59 | Professional | 54 · Surgery only | $223.87 | $263.03 | $323.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $44.67 Median $52.48 Typical High $64.57 | Professional | 55 · Aftercare only | $44.67 | $52.48 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $29.51 Median $35.48 Typical High $42.66 | Professional | 56 · Pre-op care only | $29.51 | $35.48 | $42.66 |
Where South Dakota sits
The same service costs 6.3 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 $7,350MT $1,166
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.