How much rates vary
Facilitymedian $5,370 · 10th to 90th $589 to $14,125Professionalmedian $1,175 · 10th to 90th $309 to $5,370
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 $602.56 Median $2,884.03 Typical High $6,760.83 | Facility | None | $602.56 | $2,884.03 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $229.09 Median $758.58 Typical High $2,884.03 | Professional | None | $229.09 | $758.58 | $2,884.03 |
Cigna Setting Facility Modifier None Typical Low $6,309.57 Median $9,549.93 Typical High $12,022.64 | Facility | None | $6,309.57 | $9,549.93 | $12,022.64 |
Cigna Setting Professional Modifier None Typical Low $645.65 Median $1,023.29 Typical High $5,011.87 | Professional | None | $645.65 | $1,023.29 | $5,011.87 |
Hally Health Setting Professional Modifier None Typical Low $302.00 Median $363.08 Typical High $2,691.53 | Professional | None | $302.00 | $363.08 | $2,691.53 |
Medica Setting Facility Modifier None Typical Low $426.58 Median $4,677.35 Typical High $14,454.40 | Facility | None | $426.58 | $4,677.35 | $14,454.40 |
Medica Setting Professional Modifier None Typical Low $269.15 Median $2,570.40 Typical High $15,848.93 | Professional | None | $269.15 | $2,570.40 | $15,848.93 |
Midlands Setting Professional Modifier None Typical Low $549.54 Median $3,548.13 Typical High $4,466.84 | Professional | None | $549.54 | $3,548.13 | $4,466.84 |
Midlands Setting Facility Modifier None Typical Low $6,309.57 Median $9,549.93 Typical High $12,022.64 | Facility | None | $6,309.57 | $9,549.93 | $12,022.64 |
Midlands Setting Professional Modifier None Typical Low $281.84 Median $724.44 Typical High $6,025.60 | Professional | None | $281.84 | $724.44 | $6,025.60 |
United Setting Facility Modifier None Typical Low $1,819.70 Median $6,309.57 Typical High $16,982.44 | Facility | None | $1,819.70 | $6,309.57 | $16,982.44 |
United Setting Professional Modifier None Typical Low $234.42 Median $794.33 Typical High $4,365.16 | Professional | None | $234.42 | $794.33 | $4,365.16 |
Wellmark Setting Professional Modifier None Typical Low $588.84 Median $691.83 Typical High $5,248.07 | Professional | None | $588.84 | $691.83 | $5,248.07 |
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 $154.88 Median $234.42 Typical High $1,445.44 | Professional | 52 · Reduced service | $154.88 | $234.42 | $1,445.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $61.66 Median $93.33 Typical High $575.44 | Professional | 53 · Discontinued | $61.66 | $93.33 | $575.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $229.09 Median $354.81 Typical High $2,137.96 | Professional | 54 · Surgery only | $229.09 | $354.81 | $2,137.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $46.77 Median $70.79 Typical High $436.52 | Professional | 55 · Aftercare only | $46.77 | $70.79 | $436.52 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $46.77 Typical High $288.40 | Professional | 56 · Pre-op care only | $30.90 | $46.77 | $288.40 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $213.80 Median $331.13 Typical High $1,995.26 | Professional | 78 · Unplanned return to OR | $213.80 | $331.13 | $1,995.26 |
Where Iowa sits
The same service costs 13.1 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 $15,603MT $1,192
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.