How much rates vary
Facilitymedian $148 · 10th to 90th $39 to $3,631Professionalmedian $89 · 10th to 90th $46 to $158
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 $66.07 Median $645.65 Typical High $11,481.54 | Facility | None | $66.07 | $645.65 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $51.29 Median $93.33 Typical High $158.49 | Professional | None | $51.29 | $93.33 | $158.49 |
Ambetter Setting Professional Modifier None Typical Low $54.95 Median $67.61 Typical High $125.89 | Professional | None | $54.95 | $67.61 | $125.89 |
AvMed Setting Facility Modifier None Typical Low $147.91 Median $1,819.70 Typical High $9,772.37 | Facility | None | $147.91 | $1,819.70 | $9,772.37 |
AvMed Setting Professional Modifier None Typical Low $64.57 Median $117.49 Typical High $154.88 | Professional | None | $64.57 | $117.49 | $154.88 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $66.07 Typical High $724.44 | Facility | None | $50.12 | $66.07 | $724.44 |
Cigna Setting Professional Modifier None Typical Low $45.71 Median $81.28 Typical High $134.90 | Professional | None | $45.71 | $81.28 | $134.90 |
Florida Blue Setting Facility Modifier None Typical Low $34.67 Median $74.13 Typical High $3,019.95 | Facility | None | $34.67 | $74.13 | $3,019.95 |
Florida Blue Setting Professional Modifier None Typical Low $97.72 Median $109.65 Typical High $162.18 | Professional | None | $97.72 | $109.65 | $162.18 |
Molina Setting Professional Modifier None Typical Low $48.98 Median $109.65 Typical High $173.78 | Professional | None | $48.98 | $109.65 | $173.78 |
United Setting Facility Modifier None Typical Low $81.28 Median $302.00 Typical High $2,754.23 | Facility | None | $81.28 | $302.00 | $2,754.23 |
United Setting Professional Modifier None Typical Low $43.65 Median $79.43 Typical High $158.49 | Professional | None | $43.65 | $79.43 | $158.49 |
Wellpoint Setting Professional Modifier None Typical Low $44.67 Median $95.50 Typical High $95.50 | Professional | None | $44.67 | $95.50 | $95.50 |
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 $25.12 Median $46.77 Typical High $63.10 | Professional | 52 · Reduced service | $25.12 | $46.77 | $63.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.00 Median $18.62 Typical High $25.12 | Professional | 53 · Discontinued | $10.00 | $18.62 | $25.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $38.02 Median $69.18 Typical High $93.33 | Professional | 54 · Surgery only | $38.02 | $69.18 | $93.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.59 Median $13.80 Typical High $19.05 | Professional | 55 · Aftercare only | $7.59 | $13.80 | $19.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.01 Median $9.33 Typical High $12.59 | Professional | 56 · Pre-op care only | $5.01 | $9.33 | $12.59 |
Where Florida sits
The same service costs 12.9 times more in Colorado than in Maine. 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 $2,408ME $187
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.