How much rates vary
Facilitymedian $1,905 · 10th to 90th $479 to $6,310Professionalmedian $490 · 10th to 90th $282 to $977
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 $562.34 Median $3,388.44 Typical High $6,760.83 | Facility | None | $562.34 | $3,388.44 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $190.55 Median $323.59 Typical High $562.34 | Professional | None | $190.55 | $323.59 | $562.34 |
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 $275.42 Median $489.78 Typical High $891.25 | Professional | None | $275.42 | $489.78 | $891.25 |
Hally Health Setting Professional Modifier None Typical Low $165.96 Median $389.05 Typical High $549.54 | Professional | None | $165.96 | $389.05 | $549.54 |
Medica Setting Facility Modifier None Typical Low $436.52 Median $1,071.52 Typical High $6,025.60 | Facility | None | $436.52 | $1,071.52 | $6,025.60 |
Medica Setting Professional Modifier None Typical Low $398.11 Median $707.95 Typical High $2,454.71 | Professional | None | $398.11 | $707.95 | $2,454.71 |
Midlands Setting Professional Modifier None Typical Low $407.38 Median $537.03 Typical High $831.76 | Professional | None | $407.38 | $537.03 | $831.76 |
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 $602.56 Median $602.56 Typical High $602.56 | Professional | None | $602.56 | $602.56 | $602.56 |
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 $208.93 Median $436.52 Typical High $851.14 | Professional | None | $208.93 | $436.52 | $851.14 |
Wellmark Setting Professional Modifier None Typical Low $331.13 Median $389.05 Typical High $812.83 | Professional | None | $331.13 | $389.05 | $812.83 |
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 $125.89 Median $162.18 Typical High $281.84 | Professional | 52 · Reduced service | $125.89 | $162.18 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $50.12 Median $64.57 Typical High $112.20 | Professional | 53 · Discontinued | $50.12 | $64.57 | $112.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $190.55 Median $239.88 Typical High $426.58 | Professional | 54 · Surgery only | $190.55 | $239.88 | $426.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.02 Median $47.86 Typical High $85.11 | Professional | 55 · Aftercare only | $38.02 | $47.86 | $85.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.12 Median $32.36 Typical High $56.23 | Professional | 56 · Pre-op care only | $25.12 | $32.36 | $56.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $177.83 Median $223.87 Typical High $398.11 | Professional | 78 · Unplanned return to OR | $177.83 | $223.87 | $398.11 |
Where Iowa sits
The same service costs 6.3 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 $4,654MT $736
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.