How much rates vary
Facilitymedian $759 · 10th to 90th $191 to $1,514Professionalmedian $309 · 10th to 90th $170 to $525
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 $131.83 Median $190.55 Typical High $4,365.16 | Facility | None | $131.83 | $190.55 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $112.20 Median $169.82 Typical High $245.47 | Professional | None | $112.20 | $169.82 | $245.47 |
Cigna Setting Facility Modifier None Typical Low $288.40 Median $1,202.26 Typical High $1,348.96 | Facility | None | $288.40 | $1,202.26 | $1,348.96 |
Cigna Setting Professional Modifier None Typical Low $302.00 Median $389.05 Typical High $575.44 | Professional | None | $302.00 | $389.05 | $575.44 |
Medica Setting Facility Modifier None Typical Low $190.55 Median $288.40 Typical High $1,202.26 | Facility | None | $190.55 | $288.40 | $1,202.26 |
Medica Setting Professional Modifier None Typical Low $194.98 Median $501.19 Typical High $1,659.59 | Professional | None | $194.98 | $501.19 | $1,659.59 |
Midlands Setting Professional Modifier None Typical Low $302.00 Median $302.00 Typical High $426.58 | Professional | None | $302.00 | $302.00 | $426.58 |
Midlands Setting Facility Modifier None Typical Low $645.65 Median $1,288.25 Typical High $1,513.56 | Facility | None | $645.65 | $1,288.25 | $1,513.56 |
Midlands Setting Professional Modifier None Typical Low $269.15 Median $269.15 Typical High $363.08 | Professional | None | $269.15 | $269.15 | $363.08 |
Sanford Health Plan Setting Professional Modifier None Typical Low $181.97 Median $263.03 Typical High $363.08 | Professional | None | $181.97 | $263.03 | $363.08 |
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 $154.88 Median $354.81 Typical High $524.81 | Professional | None | $154.88 | $354.81 | $524.81 |
Wellmark Setting Professional Modifier None Typical Low $245.47 Median $302.00 Typical High $489.78 | Professional | None | $245.47 | $302.00 | $489.78 |
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 $56.23 Median $64.57 Typical High $93.33 | Professional | 52 · Reduced service | $56.23 | $64.57 | $93.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.39 Median $26.30 Typical High $37.15 | Professional | 53 · Discontinued | $22.39 | $26.30 | $37.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $83.18 Median $97.72 Typical High $141.25 | Professional | 54 · Surgery only | $83.18 | $97.72 | $141.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $19.50 Typical High $28.18 | Professional | 55 · Aftercare only | $16.98 | $19.50 | $28.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $13.18 Typical High $18.62 | Professional | 56 · Pre-op care only | $11.22 | $13.18 | $18.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $77.62 Median $91.20 Typical High $131.83 | Professional | 78 · Unplanned return to OR | $77.62 | $91.20 | $131.83 |
Where South Dakota 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.