How much rates vary
Facilitymedian $1,738 · 10th to 90th $832 to $5,888Professionalmedian $1,000 · 10th to 90th $589 to $2,570
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 $2,511.89 Typical High $6,760.83 | Facility | None | $602.56 | $2,511.89 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $389.05 Median $794.33 Typical High $1,230.27 | Professional | None | $389.05 | $794.33 | $1,230.27 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $1,548.82 Typical High $1,862.09 | Facility | None | $645.65 | $1,548.82 | $1,862.09 |
Cigna Setting Professional Modifier None Typical Low $741.31 Median $1,288.25 Typical High $1,905.46 | Professional | None | $741.31 | $1,288.25 | $1,905.46 |
Hally Health Setting Professional Modifier None Typical Low $398.11 Median $954.99 Typical High $1,513.56 | Professional | None | $398.11 | $954.99 | $1,513.56 |
Medica Setting Facility Modifier None Typical Low $776.25 Median $1,621.81 Typical High $5,370.32 | Facility | None | $776.25 | $1,621.81 | $5,370.32 |
Medica Setting Professional Modifier None Typical Low $707.95 Median $1,202.26 Typical High $6,606.93 | Professional | None | $707.95 | $1,202.26 | $6,606.93 |
Midlands Setting Professional Modifier None Typical Low $630.96 Median $1,348.96 Typical High $1,905.46 | Professional | None | $630.96 | $1,348.96 | $1,905.46 |
Midlands Setting Facility Modifier None Typical Low $1,000.00 Median $1,548.82 Typical High $1,862.09 | Facility | None | $1,000.00 | $1,548.82 | $1,862.09 |
Midlands Setting Professional Modifier None Typical Low $645.65 Median $1,174.90 Typical High $2,089.30 | Professional | None | $645.65 | $1,174.90 | $2,089.30 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $3,311.31 Typical High $6,456.54 | Facility | None | $1,258.93 | $3,311.31 | $6,456.54 |
United Setting Professional Modifier None Typical Low $389.05 Median $707.95 Typical High $1,479.11 | Professional | None | $389.05 | $707.95 | $1,479.11 |
Wellmark Setting Professional Modifier None Typical Low $851.14 Median $1,288.25 Typical High $2,570.40 | Professional | None | $851.14 | $1,288.25 | $2,570.40 |
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 $186.21 Median $295.12 Typical High $616.60 | Professional | 52 · Reduced service | $186.21 | $295.12 | $616.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $74.13 Median $117.49 Typical High $245.47 | Professional | 53 · Discontinued | $74.13 | $117.49 | $245.47 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $281.84 Median $446.68 Typical High $912.01 | Professional | 54 · Surgery only | $281.84 | $446.68 | $912.01 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $89.13 Typical High $181.97 | Professional | 55 · Aftercare only | $56.23 | $89.13 | $181.97 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $58.88 Typical High $123.03 | Professional | 56 · Pre-op care only | $37.15 | $58.88 | $123.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $263.03 Median $416.87 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $263.03 | $416.87 | $851.14 |
Where Iowa sits
The same service costs 3.2 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 $4,968MT $1,567
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.