How much rates vary
Facilitymedian $2,138 · 10th to 90th $676 to $6,457Professionalmedian $661 · 10th to 90th $380 to $1,047
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 $645.65 Median $3,548.13 Typical High $6,760.83 | Facility | None | $645.65 | $3,548.13 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $346.74 Median $645.65 Typical High $645.65 | Professional | None | $346.74 | $645.65 | $645.65 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $1,737.80 Typical High $2,137.96 | Facility | None | $954.99 | $1,737.80 | $2,137.96 |
Cigna Setting Professional Modifier None Typical Low $426.58 Median $794.33 Typical High $1,071.52 | Professional | None | $426.58 | $794.33 | $1,071.52 |
Hally Health Setting Professional Modifier None Typical Low $331.13 Median $478.63 Typical High $758.58 | Professional | None | $331.13 | $478.63 | $758.58 |
Medica Setting Facility Modifier None Typical Low $562.34 Median $1,621.81 Typical High $6,165.95 | Facility | None | $562.34 | $1,621.81 | $6,165.95 |
Medica Setting Professional Modifier None Typical Low $416.87 Median $794.33 Typical High $2,754.23 | Professional | None | $416.87 | $794.33 | $2,754.23 |
Midlands Setting Professional Modifier None Typical Low $794.33 Median $794.33 Typical High $1,000.00 | Professional | None | $794.33 | $794.33 | $1,000.00 |
Midlands Setting Facility Modifier None Typical Low $1,047.13 Median $1,698.24 Typical High $2,137.96 | Facility | None | $1,047.13 | $1,698.24 | $2,137.96 |
Midlands Setting Professional Modifier None Typical Low $724.44 Median $724.44 Typical High $724.44 | Professional | None | $724.44 | $724.44 | $724.44 |
Oscar Health Setting Professional Modifier None Typical Low $316.23 Median $575.44 Typical High $707.95 | Professional | None | $316.23 | $575.44 | $707.95 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $3,548.13 Typical High $7,413.10 | Facility | None | $1,258.93 | $3,548.13 | $7,413.10 |
United Setting Professional Modifier None Typical Low $389.05 Median $562.34 Typical High $1,047.13 | Professional | None | $389.05 | $562.34 | $1,047.13 |
Wellmark Setting Professional Modifier None Typical Low $660.69 Median $660.69 Typical High $776.25 | Professional | None | $660.69 | $660.69 | $776.25 |
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 $190.55 Median $323.59 Typical High $323.59 | Professional | 52 · Reduced service | $190.55 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $128.82 Typical High $128.82 | Professional | 53 · Discontinued | $75.86 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $288.40 Median $489.78 Typical High $489.78 | Professional | 54 · Surgery only | $288.40 | $489.78 | $489.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $97.72 Typical High $97.72 | Professional | 55 · Aftercare only | $57.54 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $64.57 Typical High $64.57 | Professional | 56 · Pre-op care only | $38.02 | $64.57 | $64.57 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $269.15 Median $457.09 Typical High $457.09 | Professional | 78 · Unplanned return to OR | $269.15 | $457.09 | $457.09 |
Where Iowa sits
The same service costs 4.5 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 $4,914MT $1,099
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.