How much rates vary
Facilitymedian $1,549 · 10th to 90th $550 to $5,754Professionalmedian $603 · 10th to 90th $347 to $1,148
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 $389.05 Median $1,202.26 Typical High $6,309.57 | Facility | None | $389.05 | $1,202.26 | $6,309.57 |
Aetna Setting Professional Modifier None Typical Low $208.93 Median $446.68 Typical High $1,000.00 | Professional | None | $208.93 | $446.68 | $1,000.00 |
Cigna Setting Facility Modifier None Typical Low $562.34 Median $1,621.81 Typical High $1,995.26 | Facility | None | $562.34 | $1,621.81 | $1,995.26 |
Cigna Setting Professional Modifier None Typical Low $426.58 Median $602.56 Typical High $1,023.29 | Professional | None | $426.58 | $602.56 | $1,023.29 |
Hally Health Setting Professional Modifier None Typical Low $177.83 Median $407.38 Typical High $1,202.26 | Professional | None | $177.83 | $407.38 | $1,202.26 |
Medica Setting Facility Modifier None Typical Low $549.54 Median $1,148.15 Typical High $5,370.32 | Facility | None | $549.54 | $1,148.15 | $5,370.32 |
Medica Setting Professional Modifier None Typical Low $416.87 Median $933.25 Typical High $3,235.94 | Professional | None | $416.87 | $933.25 | $3,235.94 |
Midlands Setting Professional Modifier None Typical Low $363.08 Median $812.83 Typical High $954.99 | Professional | None | $363.08 | $812.83 | $954.99 |
Midlands Setting Facility Modifier None Typical Low $562.34 Median $1,548.82 Typical High $1,995.26 | Facility | None | $562.34 | $1,548.82 | $1,995.26 |
Midlands Setting Professional Modifier None Typical Low $426.58 Median $831.76 Typical High $1,148.15 | Professional | None | $426.58 | $831.76 | $1,148.15 |
Oscar Health Setting Facility Modifier None Typical Low $933.25 Median $933.25 Typical High $933.25 | Facility | None | $933.25 | $933.25 | $933.25 |
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 $263.03 Median $524.81 Typical High $1,071.52 | Professional | None | $263.03 | $524.81 | $1,071.52 |
Wellmark Setting Professional Modifier None Typical Low $346.74 Median $724.44 Typical High $1,071.52 | Professional | None | $346.74 | $724.44 | $1,071.52 |
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 $95.50 Median $199.53 Typical High $302.00 | Professional | 52 · Reduced service | $95.50 | $199.53 | $302.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $79.43 Typical High $123.03 | Professional | 53 · Discontinued | $38.02 | $79.43 | $123.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $144.54 Median $302.00 Typical High $457.09 | Professional | 54 · Surgery only | $144.54 | $302.00 | $457.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $60.26 Typical High $91.20 | Professional | 55 · Aftercare only | $28.84 | $60.26 | $91.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $39.81 Typical High $60.26 | Professional | 56 · Pre-op care only | $19.05 | $39.81 | $60.26 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $134.90 Median $281.84 Typical High $426.58 | Professional | 78 · Unplanned return to OR | $134.90 | $281.84 | $426.58 |
Where Iowa sits
The same service costs 4.6 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 $4,728MT $1,029
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.