How much rates vary
Facilitymedian $3,236 · 10th to 90th $1,175 to $14,125Professionalmedian $575 · 10th to 90th $85 to $1,230
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 $645.65 Median $3,801.89 Typical High $10,964.78 | Facility | None | $645.65 | $3,801.89 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $616.60 Median $831.76 Typical High $1,318.26 | Professional | None | $616.60 | $831.76 | $1,318.26 |
Ambetter Setting Professional Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $1,096.48 | Professional | None | $1,096.48 | $1,096.48 | $1,096.48 |
AvMed Setting Facility Modifier None Typical Low $549.54 Median $1,995.26 Typical High $9,772.37 | Facility | None | $549.54 | $1,995.26 | $9,772.37 |
AvMed Setting Professional Modifier None Typical Low $426.58 Median $758.58 Typical High $1,071.52 | Professional | None | $426.58 | $758.58 | $1,071.52 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $3,235.94 Typical High $11,481.54 | Facility | None | $446.68 | $3,235.94 | $11,481.54 |
Cigna Setting Professional Modifier None Typical Low $549.54 Median $741.31 Typical High $1,698.24 | Professional | None | $549.54 | $741.31 | $1,698.24 |
Florida Blue Setting Facility Modifier None Typical Low $1,737.80 Median $3,548.13 Typical High $16,982.44 | Facility | None | $1,737.80 | $3,548.13 | $16,982.44 |
Florida Blue Setting Professional Modifier None Typical Low $416.87 Median $501.19 Typical High $812.83 | Professional | None | $416.87 | $501.19 | $812.83 |
Molina Setting Professional Modifier None Typical Low $72.44 Median $501.19 Typical High $1,071.52 | Professional | None | $72.44 | $501.19 | $1,071.52 |
United Setting Facility Modifier None Typical Low $1,348.96 Median $3,801.89 Typical High $15,135.61 | Facility | None | $1,348.96 | $3,801.89 | $15,135.61 |
United Setting Professional Modifier None Typical Low $60.26 Median $977.24 Typical High $1,995.26 | Professional | None | $60.26 | $977.24 | $1,995.26 |
Wellpoint Setting Professional Modifier None Typical Low $549.54 Median $549.54 Typical High $724.44 | Professional | None | $549.54 | $549.54 | $724.44 |
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 $309.03 Median $407.38 Typical High $446.68 | Professional | 52 · Reduced service | $309.03 | $407.38 | $446.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $162.18 Typical High $177.83 | Professional | 53 · Discontinued | $123.03 | $162.18 | $177.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $616.60 Typical High $660.69 | Professional | 54 · Surgery only | $457.09 | $616.60 | $660.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $123.03 Typical High $131.83 | Professional | 55 · Aftercare only | $91.20 | $123.03 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $81.28 Typical High $89.13 | Professional | 56 · Pre-op care only | $61.66 | $81.28 | $89.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $575.44 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $426.58 | $575.44 | $616.60 |
Where Florida sits
The same service costs 6.0 times more in Colorado than in Hawaii. 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 $12,924HI $2,150
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.