How much rates vary
Facilitymedian $3,467 · 10th to 90th $513 to $6,918Professionalmedian $1,096 · 10th to 90th $331 to $10,000
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 $354.81 Median $2,041.74 Typical High $4,365.16 | Facility | None | $354.81 | $2,041.74 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $354.81 Median $933.25 Typical High $3,801.89 | Professional | None | $354.81 | $933.25 | $3,801.89 |
Cigna Setting Facility Modifier None Typical Low $5,623.41 Median $5,888.44 Typical High $11,748.98 | Facility | None | $5,623.41 | $5,888.44 | $11,748.98 |
Cigna Setting Professional Modifier None Typical Low $691.83 Median $1,202.26 Typical High $9,120.11 | Professional | None | $691.83 | $1,202.26 | $9,120.11 |
Medica Setting Facility Modifier None Typical Low $426.58 Median $3,235.94 Typical High $5,623.41 | Facility | None | $426.58 | $3,235.94 | $5,623.41 |
Medica Setting Professional Modifier None Typical Low $245.47 Median $3,890.45 Typical High $28,183.83 | Professional | None | $245.47 | $3,890.45 | $28,183.83 |
Midlands Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $3,890.45 | Professional | None | $812.83 | $812.83 | $3,890.45 |
Midlands Setting Facility Modifier None Typical Low $645.65 Median $5,888.44 Typical High $13,803.84 | Facility | None | $645.65 | $5,888.44 | $13,803.84 |
Midlands Setting Professional Modifier None Typical Low $338.84 Median $407.38 Typical High $2,290.87 | Professional | None | $338.84 | $407.38 | $2,290.87 |
Sanford Health Plan Setting Professional Modifier None Typical Low $234.42 Median $891.25 Typical High $6,918.31 | Professional | None | $234.42 | $891.25 | $6,918.31 |
United Setting Facility Modifier None Typical Low $3,235.94 Median $3,235.94 Typical High $3,890.45 | Facility | None | $3,235.94 | $3,235.94 | $3,890.45 |
United Setting Professional Modifier None Typical Low $223.87 Median $691.83 Typical High $5,754.40 | Professional | None | $223.87 | $691.83 | $5,754.40 |
Wellmark Setting Professional Modifier None Typical Low $933.25 Median $1,096.48 Typical High $11,748.98 | Professional | None | $933.25 | $1,096.48 | $11,748.98 |
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 $177.83 Median $467.74 Typical High $1,905.46 | Professional | 52 · Reduced service | $177.83 | $467.74 | $1,905.46 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $186.21 Typical High $758.58 | Professional | 53 · Discontinued | $70.79 | $186.21 | $758.58 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $691.83 Typical High $2,884.03 | Professional | 54 · Surgery only | $263.03 | $691.83 | $2,884.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $138.04 Typical High $575.44 | Professional | 55 · Aftercare only | $52.48 | $138.04 | $575.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $93.33 Typical High $380.19 | Professional | 56 · Pre-op care only | $35.48 | $93.33 | $380.19 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $245.47 Median $645.65 Typical High $2,691.53 | Professional | 78 · Unplanned return to OR | $245.47 | $645.65 | $2,691.53 |
Where South Dakota sits
The same service costs 18.4 times more in Alabama 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
AL $30,876MT $1,679
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.