How much rates vary
Facilitymedian $1,820 · 10th to 90th $389 to $6,310Professionalmedian $282 · 10th to 90th $229 to $1,905
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 $758.58 Median $2,570.40 Typical High $7,585.78 | Facility | None | $758.58 | $2,570.40 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $912.01 | Professional | None | $281.84 | $281.84 | $912.01 |
Cigna Setting Facility Modifier None Typical Low $407.38 Median $1,202.26 Typical High $1,445.44 | Facility | None | $407.38 | $1,202.26 | $1,445.44 |
Cigna Setting Professional Modifier None Typical Low $245.47 Median $288.40 Typical High $407.38 | Professional | None | $245.47 | $288.40 | $407.38 |
Medica Setting Facility Modifier None Typical Low $371.54 Median $1,148.15 Typical High $6,025.60 | Facility | None | $371.54 | $1,148.15 | $6,025.60 |
Medica Setting Professional Modifier None Typical Low $229.09 Median $281.84 Typical High $1,905.46 | Professional | None | $229.09 | $281.84 | $1,905.46 |
United Setting Facility Modifier None Typical Low $933.25 Median $2,951.21 Typical High $6,165.95 | Facility | None | $933.25 | $2,951.21 | $6,165.95 |
United Setting Professional Modifier None Typical Low $213.80 Median $269.15 Typical High $338.84 | Professional | None | $213.80 | $269.15 | $338.84 |
5 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 $141.25 Median $141.25 Typical High $141.25 | Professional | 52 · Reduced service | $141.25 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $56.23 Typical High $57.54 | Professional | 53 · Discontinued | $56.23 | $56.23 | $57.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $213.80 Median $213.80 Typical High $213.80 | Professional | 54 · Surgery only | $213.80 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $42.66 Median $42.66 Typical High $42.66 | Professional | 55 · Aftercare only | $42.66 | $42.66 | $42.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $28.18 Typical High $28.18 | Professional | 56 · Pre-op care only | $28.18 | $28.18 | $28.18 |
Where Oklahoma sits
The same service costs 6.4 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 $4,783MT $743
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.