How much rates vary
Facilitymedian $1,096 · 10th to 90th $269 to $1,820Professionalmedian $562 · 10th to 90th $316 to $1,175
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 $223.87 Median $2,290.87 Typical High $8,912.51 | Facility | None | $223.87 | $2,290.87 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $162.18 Median $371.54 Typical High $524.81 | Professional | None | $162.18 | $371.54 | $524.81 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $812.83 Typical High $1,288.25 | Facility | None | $524.81 | $812.83 | $1,288.25 |
Cigna Setting Professional Modifier None Typical Low $446.68 Median $562.34 Typical High $1,096.48 | Professional | None | $446.68 | $562.34 | $1,096.48 |
Medica Setting Facility Modifier None Typical Low $269.15 Median $630.96 Typical High $1,698.24 | Facility | None | $269.15 | $630.96 | $1,698.24 |
Medica Setting Professional Modifier None Typical Low $478.63 Median $1,047.13 Typical High $3,235.94 | Professional | None | $478.63 | $1,047.13 | $3,235.94 |
Midlands Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $954.99 | Professional | None | $524.81 | $524.81 | $954.99 |
Midlands Setting Facility Modifier None Typical Low $524.81 Median $1,288.25 Typical High $1,513.56 | Facility | None | $524.81 | $1,288.25 | $1,513.56 |
Midlands Setting Professional Modifier None Typical Low $467.74 Median $512.86 Typical High $933.25 | Professional | None | $467.74 | $512.86 | $933.25 |
Sanford Health Plan Setting Professional Modifier None Typical Low $309.03 Median $512.86 Typical High $831.76 | Professional | None | $309.03 | $512.86 | $831.76 |
United Setting Facility Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $1,819.70 | Facility | None | $1,513.56 | $1,513.56 | $1,819.70 |
United Setting Professional Modifier None Typical Low $275.42 Median $602.56 Typical High $1,174.90 | Professional | None | $275.42 | $602.56 | $1,174.90 |
Wellmark Setting Professional Modifier None Typical Low $363.08 Median $426.58 Typical High $1,122.02 | Professional | None | $363.08 | $426.58 | $1,122.02 |
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 $79.43 Median $186.21 Typical High $218.78 | Professional | 52 · Reduced service | $79.43 | $186.21 | $218.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $75.86 Typical High $87.10 | Professional | 53 · Discontinued | $32.36 | $75.86 | $87.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $120.23 Median $281.84 Typical High $331.13 | Professional | 54 · Surgery only | $120.23 | $281.84 | $331.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $56.23 Typical High $66.07 | Professional | 55 · Aftercare only | $23.99 | $56.23 | $66.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $37.15 Typical High $43.65 | Professional | 56 · Pre-op care only | $16.22 | $37.15 | $43.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $112.20 Median $263.03 Typical High $309.03 | Professional | 78 · Unplanned return to OR | $112.20 | $263.03 | $309.03 |
Where South Dakota 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.