How much rates vary
Facilitymedian $1,585 · 10th to 90th $550 to $6,166Professionalmedian $214 · 10th to 90th $166 to $347
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 $549.54 Median $3,715.35 Typical High $11,481.54 | Facility | None | $549.54 | $3,715.35 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $208.93 Median $234.42 Typical High $275.42 | Professional | None | $208.93 | $234.42 | $275.42 |
AvMed Setting Facility Modifier None Typical Low $234.42 Median $2,137.96 Typical High $11,748.98 | Facility | None | $234.42 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $199.53 Median $251.19 Typical High $288.40 | Professional | None | $199.53 | $251.19 | $288.40 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $1,023.29 Typical High $2,691.53 | Facility | None | $457.09 | $1,023.29 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $181.97 Median $194.98 Typical High $389.05 | Professional | None | $181.97 | $194.98 | $389.05 |
Florida Blue Setting Facility Modifier None Typical Low $891.25 Median $1,819.70 Typical High $6,309.57 | Facility | None | $891.25 | $1,819.70 | $6,309.57 |
Florida Blue Setting Professional Modifier None Typical Low $109.65 Median $181.97 Typical High $257.04 | Professional | None | $109.65 | $181.97 | $257.04 |
Molina Setting Professional Modifier None Typical Low $165.96 Median $204.17 Typical High $354.81 | Professional | None | $165.96 | $204.17 | $354.81 |
United Setting Facility Modifier None Typical Low $398.11 Median $1,000.00 Typical High $5,623.41 | Facility | None | $398.11 | $1,000.00 | $5,623.41 |
United Setting Professional Modifier None Typical Low $165.96 Median $213.80 Typical High $416.87 | Professional | None | $165.96 | $213.80 | $416.87 |
Wellpoint Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $234.42 | Professional | None | $165.96 | $165.96 | $234.42 |
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 $104.71 Median $117.49 Typical High $134.90 | Professional | 52 · Reduced service | $104.71 | $117.49 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $46.77 Typical High $53.70 | Professional | 53 · Discontinued | $41.69 | $46.77 | $53.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $158.49 Median $173.78 Typical High $204.17 | Professional | 54 · Surgery only | $158.49 | $173.78 | $204.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $35.48 Typical High $40.74 | Professional | 55 · Aftercare only | $31.62 | $35.48 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $23.44 Typical High $26.92 | Professional | 56 · Pre-op care only | $20.89 | $23.44 | $26.92 |
Where Florida sits
The same service costs 6.2 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 $4,689MT $752
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.