How much rates vary
Facilitymedian $186 · 10th to 90th $126 to $537Professionalmedian $331 · 10th to 90th $191 to $589
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 $213.80 Typical High $4,365.16 | Facility | None | $131.83 | $213.80 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $109.65 Median $190.55 Typical High $302.00 | Professional | None | $109.65 | $190.55 | $302.00 |
Cigna Setting Facility Modifier None Typical Low $141.25 Median $186.21 Typical High $407.38 | Facility | None | $141.25 | $186.21 | $407.38 |
Cigna Setting Professional Modifier None Typical Low $302.00 Median $416.87 Typical High $645.65 | Professional | None | $302.00 | $416.87 | $645.65 |
Medica Setting Facility Modifier None Typical Low $125.89 Median $223.87 Typical High $338.84 | Facility | None | $125.89 | $223.87 | $338.84 |
Medica Setting Professional Modifier None Typical Low $223.87 Median $562.34 Typical High $1,659.59 | Professional | None | $223.87 | $562.34 | $1,659.59 |
Midlands Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $478.63 | Professional | None | $309.03 | $309.03 | $478.63 |
Midlands Setting Facility Modifier None Typical Low $141.25 Median $186.21 Typical High $645.65 | Facility | None | $141.25 | $186.21 | $645.65 |
Midlands Setting Professional Modifier None Typical Low $275.42 Median $275.42 Typical High $416.87 | Professional | None | $275.42 | $275.42 | $416.87 |
Sanford Health Plan Setting Professional Modifier None Typical Low $218.78 Median $288.40 Typical High $407.38 | Professional | None | $218.78 | $288.40 | $407.38 |
United Setting Facility Modifier None Typical Low $125.89 Median $125.89 Typical High $223.87 | Facility | None | $125.89 | $125.89 | $223.87 |
United Setting Professional Modifier None Typical Low $158.49 Median $371.54 Typical High $588.84 | Professional | None | $158.49 | $371.54 | $588.84 |
Wellmark Setting Professional Modifier None Typical Low $257.04 Median $316.23 Typical High $616.60 | Professional | None | $257.04 | $316.23 | $616.60 |
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 $54.95 Median $66.07 Typical High $104.71 | Professional | 52 · Reduced service | $54.95 | $66.07 | $104.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $26.30 Typical High $41.69 | Professional | 53 · Discontinued | $21.88 | $26.30 | $41.69 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $83.18 Median $100.00 Typical High $154.88 | Professional | 54 · Surgery only | $83.18 | $100.00 | $154.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $19.95 Typical High $31.62 | Professional | 55 · Aftercare only | $16.60 | $19.95 | $31.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $13.18 Typical High $20.89 | Professional | 56 · Pre-op care only | $10.96 | $13.18 | $20.89 |
Where South Dakota sits
The same service costs 8.8 times more in New York than in Alabama. 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
NY $2,761AL $314
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.