How much rates vary
Facilitymedian $1,698 · 10th to 90th $724 to $9,550Professionalmedian $200 · 10th to 90th $129 to $331
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 $257.04 Median $3,090.30 Typical High $10,964.78 | Facility | None | $257.04 | $3,090.30 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $141.25 Median $199.53 Typical High $323.59 | Professional | None | $141.25 | $199.53 | $323.59 |
Ambetter Setting Professional Modifier None Typical Low $199.53 Median $204.17 Typical High $316.23 | Professional | None | $199.53 | $204.17 | $316.23 |
AvMed Setting Facility Modifier None Typical Low $323.59 Median $1,479.11 Typical High $9,549.93 | Facility | None | $323.59 | $1,479.11 | $9,549.93 |
AvMed Setting Professional Modifier None Typical Low $181.97 Median $229.09 Typical High $323.59 | Professional | None | $181.97 | $229.09 | $323.59 |
Cigna Setting Facility Modifier None Typical Low $436.52 Median $1,445.44 Typical High $2,344.23 | Facility | None | $436.52 | $1,445.44 | $2,344.23 |
Cigna Setting Professional Modifier None Typical Low $138.04 Median $194.98 Typical High $309.03 | Professional | None | $138.04 | $194.98 | $309.03 |
Florida Blue Setting Facility Modifier None Typical Low $831.76 Median $1,819.70 Typical High $11,748.98 | Facility | None | $831.76 | $1,819.70 | $11,748.98 |
Florida Blue Setting Professional Modifier None Typical Low $147.91 Median $213.80 Typical High $331.13 | Professional | None | $147.91 | $213.80 | $331.13 |
Molina Setting Professional Modifier None Typical Low $31.62 Median $223.87 Typical High $371.54 | Professional | None | $31.62 | $223.87 | $371.54 |
United Setting Facility Modifier None Typical Low $794.33 Median $1,778.28 Typical High $7,585.78 | Facility | None | $794.33 | $1,778.28 | $7,585.78 |
United Setting Professional Modifier None Typical Low $120.23 Median $186.21 Typical High $338.84 | Professional | None | $120.23 | $186.21 | $338.84 |
Wellpoint Setting Professional Modifier None Typical Low $138.04 Median $223.87 Typical High $223.87 | Professional | None | $138.04 | $223.87 | $223.87 |
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 $91.20 Typical High $107.15 | Professional | 52 · Reduced service | $70.79 | $91.20 | $107.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $36.31 Typical High $42.66 | Professional | 53 · Discontinued | $28.18 | $36.31 | $42.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $107.15 Median $138.04 Typical High $162.18 | Professional | 54 · Surgery only | $107.15 | $138.04 | $162.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.38 Median $27.54 Typical High $32.36 | Professional | 55 · Aftercare only | $21.38 | $27.54 | $32.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $18.20 Typical High $21.38 | Professional | 56 · Pre-op care only | $14.13 | $18.20 | $21.38 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $100.00 Median $128.82 Typical High $151.36 | Professional | 78 · Unplanned return to OR | $100.00 | $128.82 | $151.36 |
Where Florida sits
The same service costs 9.3 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 $5,912MT $637
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.