How much rates vary
Facilitymedian $3,236 · 10th to 90th $407 to $6,607Professionalmedian $912 · 10th to 90th $269 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 $338.84 Median $1,905.46 Typical High $4,365.16 | Facility | None | $338.84 | $1,905.46 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $151.36 Median $309.03 Typical High $2,137.96 | Professional | None | $151.36 | $309.03 | $2,137.96 |
Cigna Setting Facility Modifier None Typical Low $3,090.30 Median $5,888.44 Typical High $7,762.47 | Facility | None | $3,090.30 | $5,888.44 | $7,762.47 |
Cigna Setting Professional Modifier None Typical Low $676.08 Median $1,148.15 Typical High $5,754.40 | Professional | None | $676.08 | $1,148.15 | $5,754.40 |
Medica Setting Facility Modifier None Typical Low $389.05 Median $3,090.30 Typical High $3,467.37 | Facility | None | $389.05 | $3,090.30 | $3,467.37 |
Medica Setting Professional Modifier None Typical Low $251.19 Median $3,548.13 Typical High $15,848.93 | Professional | None | $251.19 | $3,548.13 | $15,848.93 |
Midlands Setting Professional Modifier None Typical Low $794.33 Median $794.33 Typical High $3,548.13 | Professional | None | $794.33 | $794.33 | $3,548.13 |
Midlands Setting Facility Modifier None Typical Low $5,888.44 Median $6,760.83 Typical High $9,332.54 | Facility | None | $5,888.44 | $6,760.83 | $9,332.54 |
Midlands Setting Professional Modifier None Typical Low $338.84 Median $389.05 Typical High $2,137.96 | Professional | None | $338.84 | $389.05 | $2,137.96 |
Sanford Health Plan Setting Professional Modifier None Typical Low $239.88 Median $630.96 Typical High $3,801.89 | Professional | None | $239.88 | $630.96 | $3,801.89 |
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 $229.09 Median $645.65 Typical High $5,370.32 | Professional | None | $229.09 | $645.65 | $5,370.32 |
Wellmark Setting Professional Modifier None Typical Low $616.60 Median $724.44 Typical High $5,495.41 | Professional | None | $616.60 | $724.44 | $5,495.41 |
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 $134.90 Median $398.11 Typical High $1,071.52 | Professional | 52 · Reduced service | $134.90 | $398.11 | $1,071.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $53.70 Median $162.18 Typical High $426.58 | Professional | 53 · Discontinued | $53.70 | $162.18 | $426.58 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $204.17 Median $602.56 Typical High $1,584.89 | Professional | 54 · Surgery only | $204.17 | $602.56 | $1,584.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $120.23 Typical High $316.23 | Professional | 55 · Aftercare only | $40.74 | $120.23 | $316.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $81.28 Typical High $213.80 | Professional | 56 · Pre-op care only | $26.92 | $81.28 | $213.80 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $190.55 Median $562.34 Typical High $1,479.11 | Professional | 78 · Unplanned return to OR | $190.55 | $562.34 | $1,479.11 |
Where South Dakota 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.