How much rates vary
Facilitymedian $2,089 · 10th to 90th $347 to $6,457Professionalmedian $295 · 10th to 90th $151 to $501
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 $467.74 Median $3,235.94 Typical High $6,760.83 | Facility | None | $467.74 | $3,235.94 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $138.04 Median $239.88 Typical High $239.88 | Professional | None | $138.04 | $239.88 | $239.88 |
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 $199.53 Median $295.12 Typical High $398.11 | Professional | None | $199.53 | $295.12 | $398.11 |
Hally Health Setting Professional Modifier None Typical Low $123.03 Median $177.83 Typical High $331.13 | Professional | None | $123.03 | $177.83 | $331.13 |
Medica Setting Facility Modifier None Typical Low $295.12 Median $1,621.81 Typical High $6,165.95 | Facility | None | $295.12 | $1,621.81 | $6,165.95 |
Medica Setting Professional Modifier None Typical Low $190.55 Median $316.23 Typical High $1,071.52 | Professional | None | $190.55 | $316.23 | $1,071.52 |
Midlands Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $363.08 | Professional | None | $295.12 | $295.12 | $363.08 |
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 $269.15 Median $269.15 Typical High $269.15 | Professional | None | $269.15 | $269.15 | $269.15 |
Oscar Health Setting Professional Modifier None Typical Low $117.49 Median $213.80 Typical High $263.03 | Professional | None | $117.49 | $213.80 | $263.03 |
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 $147.91 Median $263.03 Typical High $501.19 | Professional | None | $147.91 | $263.03 | $501.19 |
Wellmark Setting Professional Modifier None Typical Low $245.47 Median $245.47 Typical High $288.40 | Professional | None | $245.47 | $245.47 | $288.40 |
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 $70.79 Median $120.23 Typical High $120.23 | Professional | 52 · Reduced service | $70.79 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $47.86 Typical High $47.86 | Professional | 53 · Discontinued | $28.18 | $47.86 | $47.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $107.15 Median $177.83 Typical High $177.83 | Professional | 54 · Surgery only | $107.15 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.38 Median $35.48 Typical High $35.48 | Professional | 55 · Aftercare only | $21.38 | $35.48 | $35.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $23.99 Typical High $23.99 | Professional | 56 · Pre-op care only | $14.13 | $23.99 | $23.99 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $100.00 Median $165.96 Typical High $165.96 | Professional | 78 · Unplanned return to OR | $100.00 | $165.96 | $165.96 |
Where Iowa sits
The same service costs 11.0 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 $4,556MT $413
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.