How much rates vary
Facilitymedian $3,467 · 10th to 90th $1,380 to $13,183Professionalmedian $977 · 10th to 90th $135 to $1,549
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 $851.14 Median $5,495.41 Typical High $12,882.50 | Facility | None | $851.14 | $5,495.41 | $12,882.50 |
Aetna Setting Professional Modifier None Typical Low $1,047.13 Median $1,148.15 Typical High $1,513.56 | Professional | None | $1,047.13 | $1,148.15 | $1,513.56 |
Ambetter Setting Professional Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $1,148.15 | Professional | None | $1,148.15 | $1,148.15 | $1,148.15 |
AvMed Setting Facility Modifier None Typical Low $724.44 Median $2,398.83 Typical High $9,772.37 | Facility | None | $724.44 | $2,398.83 | $9,772.37 |
AvMed Setting Professional Modifier None Typical Low $977.24 Median $1,288.25 Typical High $1,479.11 | Professional | None | $977.24 | $1,288.25 | $1,479.11 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $3,801.89 Typical High $6,606.93 | Facility | None | $707.95 | $3,801.89 | $6,606.93 |
Cigna Setting Professional Modifier None Typical Low $933.25 Median $977.24 Typical High $1,995.26 | Professional | None | $933.25 | $977.24 | $1,995.26 |
Florida Blue Setting Facility Modifier None Typical Low $1,778.28 Median $3,548.13 Typical High $16,982.44 | Facility | None | $1,778.28 | $3,548.13 | $16,982.44 |
Florida Blue Setting Professional Modifier None Typical Low $537.03 Median $1,122.02 Typical High $1,318.26 | Professional | None | $537.03 | $1,122.02 | $1,318.26 |
Molina Setting Professional Modifier None Typical Low $91.20 Median $776.25 Typical High $1,412.54 | Professional | None | $91.20 | $776.25 | $1,412.54 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $3,311.31 Typical High $12,589.25 | Facility | None | $1,230.27 | $3,311.31 | $12,589.25 |
United Setting Professional Modifier None Typical Low $870.96 Median $1,122.02 Typical High $2,187.76 | Professional | None | $870.96 | $1,122.02 | $2,187.76 |
Wellpoint Setting Professional Modifier None Typical Low $912.01 Median $912.01 Typical High $1,230.27 | Professional | None | $912.01 | $912.01 | $1,230.27 |
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 $524.81 Median $575.44 Typical High $676.08 | Professional | 52 · Reduced service | $524.81 | $575.44 | $676.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $208.93 Median $229.09 Typical High $275.42 | Professional | 53 · Discontinued | $208.93 | $229.09 | $275.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $794.33 Median $851.14 Typical High $1,023.29 | Professional | 54 · Surgery only | $794.33 | $851.14 | $1,023.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $169.82 Typical High $204.17 | Professional | 55 · Aftercare only | $158.49 | $169.82 | $204.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $104.71 Median $114.82 Typical High $134.90 | Professional | 56 · Pre-op care only | $104.71 | $114.82 | $134.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $741.31 Median $794.33 Typical High $954.99 | Professional | 78 · Unplanned return to OR | $741.31 | $794.33 | $954.99 |
Where Florida sits
The same service costs 4.0 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 $14,661HI $3,664
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.