How much rates vary
Facilitymedian $447 · 10th to 90th $158 to $759Professionalmedian $269 · 10th to 90th $148 to $479
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 $114.82 Median $1,659.59 Typical High $4,365.16 | Facility | None | $114.82 | $1,659.59 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $93.33 Median $141.25 Typical High $204.17 | Professional | None | $93.33 | $141.25 | $204.17 |
Cigna Setting Facility Modifier None Typical Low $245.47 Median $501.19 Typical High $537.03 | Facility | None | $245.47 | $501.19 | $537.03 |
Cigna Setting Professional Modifier None Typical Low $229.09 Median $323.59 Typical High $436.52 | Professional | None | $229.09 | $323.59 | $436.52 |
Medica Setting Facility Modifier None Typical Low $158.49 Median $239.88 Typical High $758.58 | Facility | None | $158.49 | $239.88 | $758.58 |
Medica Setting Professional Modifier None Typical Low $165.96 Median $426.58 Typical High $1,258.93 | Professional | None | $165.96 | $426.58 | $1,258.93 |
Midlands Setting Professional Modifier None Typical Low $269.15 Median $269.15 Typical High $398.11 | Professional | None | $269.15 | $269.15 | $398.11 |
Midlands Setting Facility Modifier None Typical Low $467.74 Median $524.81 Typical High $645.65 | Facility | None | $467.74 | $524.81 | $645.65 |
Midlands Setting Professional Modifier None Typical Low $234.42 Median $251.19 Typical High $389.05 | Professional | None | $234.42 | $251.19 | $389.05 |
Sanford Health Plan Setting Professional Modifier None Typical Low $147.91 Median $218.78 Typical High $309.03 | Professional | None | $147.91 | $218.78 | $309.03 |
United Setting Facility Modifier None Typical Low $446.68 Median $537.03 Typical High $758.58 | Facility | None | $446.68 | $537.03 | $758.58 |
United Setting Professional Modifier None Typical Low $134.90 Median $302.00 Typical High $478.63 | Professional | None | $134.90 | $302.00 | $478.63 |
Wellmark Setting Professional Modifier None Typical Low $213.80 Median $251.19 Typical High $416.87 | Professional | None | $213.80 | $251.19 | $416.87 |
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 $46.77 Median $70.79 Typical High $83.18 | Professional | 52 · Reduced service | $46.77 | $70.79 | $83.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.62 Median $28.18 Typical High $33.88 | Professional | 53 · Discontinued | $18.62 | $28.18 | $33.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $70.79 Median $107.15 Typical High $125.89 | Professional | 54 · Surgery only | $70.79 | $107.15 | $125.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.13 Median $21.38 Typical High $25.12 | Professional | 55 · Aftercare only | $14.13 | $21.38 | $25.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.33 Median $14.13 Typical High $16.60 | Professional | 56 · Pre-op care only | $9.33 | $14.13 | $16.60 |
Where South Dakota sits
The same service costs 6.3 times more in New York 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
NY $2,712MT $427
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.