How much rates vary
Facilitymedian $1,318 · 10th to 90th $372 to $4,365Professionalmedian $324 · 10th to 90th $234 to $4,074
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 $758.58 Median $2,570.40 Typical High $7,585.78 | Facility | None | $758.58 | $2,570.40 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $234.42 Median $234.42 Typical High $234.42 | Professional | None | $234.42 | $234.42 | $234.42 |
Cigna Setting Facility Modifier None Typical Low $407.38 Median $812.83 Typical High $1,000.00 | Facility | None | $407.38 | $812.83 | $1,000.00 |
Cigna Setting Professional Modifier None Typical Low $295.12 Median $323.59 Typical High $457.09 | Professional | None | $295.12 | $323.59 | $457.09 |
Medica Setting Facility Modifier None Typical Low $346.74 Median $645.65 Typical High $4,073.80 | Facility | None | $346.74 | $645.65 | $4,073.80 |
Medica Setting Professional Modifier None Typical Low $239.88 Median $426.58 Typical High $4,073.80 | Professional | None | $239.88 | $426.58 | $4,073.80 |
United Setting Facility Modifier None Typical Low $467.74 Median $2,041.74 Typical High $3,981.07 | Facility | None | $467.74 | $2,041.74 | $3,981.07 |
United Setting Professional Modifier None Typical Low $218.78 Median $295.12 Typical High $691.83 | Professional | None | $218.78 | $295.12 | $691.83 |
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 $117.49 Median $117.49 Typical High $117.49 | Professional | 52 · Reduced service | $117.49 | $117.49 | $117.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $46.77 Median $46.77 Typical High $46.77 | Professional | 53 · Discontinued | $46.77 | $46.77 | $46.77 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $173.78 Median $177.83 Typical High $177.83 | Professional | 54 · Surgery only | $173.78 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $35.48 Typical High $35.48 | Professional | 55 · Aftercare only | $34.67 | $35.48 | $35.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.44 Median $23.44 Typical High $23.44 | Professional | 56 · Pre-op care only | $23.44 | $23.44 | $23.44 |
Where Oklahoma sits
The same service costs 6.0 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 $4,737MT $787
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.