How much rates vary
Facilitymedian $1,698 · 10th to 90th $331 to $5,495Professionalmedian $347 · 10th to 90th $200 to $575
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 $269.15 Median $2,290.87 Typical High $6,760.83 | Facility | None | $269.15 | $2,290.87 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $141.25 Median $223.87 Typical High $323.59 | Professional | None | $141.25 | $223.87 | $323.59 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $1,737.80 Typical High $2,187.76 | Facility | None | $645.65 | $1,737.80 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $302.00 Median $416.87 Typical High $537.03 | Professional | None | $302.00 | $416.87 | $537.03 |
Hally Health Setting Professional Modifier None Typical Low $123.03 Median $275.42 Typical High $512.86 | Professional | None | $123.03 | $275.42 | $512.86 |
Medica Setting Facility Modifier None Typical Low $331.13 Median $645.65 Typical High $5,248.07 | Facility | None | $331.13 | $645.65 | $5,248.07 |
Medica Setting Professional Modifier None Typical Low $251.19 Median $426.58 Typical High $1,122.02 | Professional | None | $251.19 | $426.58 | $1,122.02 |
Midlands Setting Professional Modifier None Typical Low $302.00 Median $426.58 Typical High $537.03 | Professional | None | $302.00 | $426.58 | $537.03 |
Midlands Setting Facility Modifier None Typical Low $1,071.52 Median $1,737.80 Typical High $2,187.76 | Facility | None | $1,071.52 | $1,737.80 | $2,187.76 |
Midlands Setting Professional Modifier None Typical Low $251.19 Median $346.74 Typical High $602.56 | Professional | None | $251.19 | $346.74 | $602.56 |
United Setting Facility Modifier None Typical Low $724.44 Median $3,090.30 Typical High $6,165.95 | Facility | None | $724.44 | $3,090.30 | $6,165.95 |
United Setting Professional Modifier None Typical Low $151.36 Median $288.40 Typical High $501.19 | Professional | None | $151.36 | $288.40 | $501.19 |
Wellmark Setting Professional Modifier None Typical Low $245.47 Median $288.40 Typical High $467.74 | Professional | None | $245.47 | $288.40 | $467.74 |
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 $75.86 Median $109.65 Typical High $162.18 | Professional | 52 · Reduced service | $75.86 | $109.65 | $162.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $44.67 Typical High $64.57 | Professional | 53 · Discontinued | $30.20 | $44.67 | $64.57 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $112.20 Median $165.96 Typical High $245.47 | Professional | 54 · Surgery only | $112.20 | $165.96 | $245.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $33.11 Typical High $48.98 | Professional | 55 · Aftercare only | $22.39 | $33.11 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $22.39 Typical High $32.36 | Professional | 56 · Pre-op care only | $15.14 | $22.39 | $32.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $104.71 Median $154.88 Typical High $229.09 | Professional | 78 · Unplanned return to OR | $104.71 | $154.88 | $229.09 |
Where Iowa sits
The same service costs 9.9 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 $4,605MT $466
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.