How much rates vary
Facilitymedian $3,311 · 10th to 90th $1,380 to $12,882Professionalmedian $794 · 10th to 90th $93 to $1,259
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 $776.25 Median $4,786.30 Typical High $11,748.98 | Facility | None | $776.25 | $4,786.30 | $11,748.98 |
Aetna Setting Professional Modifier None Typical Low $794.33 Median $870.96 Typical High $1,148.15 | Professional | None | $794.33 | $870.96 | $1,148.15 |
AvMed Setting Facility Modifier None Typical Low $831.76 Median $2,137.96 Typical High $9,772.37 | Facility | None | $831.76 | $2,137.96 | $9,772.37 |
AvMed Setting Professional Modifier None Typical Low $831.76 Median $1,023.29 Typical High $1,174.90 | Professional | None | $831.76 | $1,023.29 | $1,174.90 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $3,467.37 Typical High $6,606.93 | Facility | None | $501.19 | $3,467.37 | $6,606.93 |
Cigna Setting Professional Modifier None Typical Low $776.25 Median $812.83 Typical High $1,584.89 | Professional | None | $776.25 | $812.83 | $1,584.89 |
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 $407.38 Median $933.25 Typical High $1,174.90 | Professional | None | $407.38 | $933.25 | $1,174.90 |
Molina Setting Professional Modifier None Typical Low $60.26 Median $645.65 Typical High $1,202.26 | Professional | None | $60.26 | $645.65 | $1,202.26 |
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 $676.08 Median $870.96 Typical High $1,737.80 | Professional | None | $676.08 | $870.96 | $1,737.80 |
Wellpoint Setting Professional Modifier None Typical Low $776.25 Median $776.25 Typical High $1,023.29 | Professional | None | $776.25 | $776.25 | $1,023.29 |
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 $398.11 Median $436.52 Typical High $562.34 | Professional | 52 · Reduced service | $398.11 | $436.52 | $562.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $173.78 Typical High $223.87 | Professional | 53 · Discontinued | $162.18 | $173.78 | $223.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $602.56 Median $660.69 Typical High $851.14 | Professional | 54 · Surgery only | $602.56 | $660.69 | $851.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $131.83 Typical High $169.82 | Professional | 55 · Aftercare only | $120.23 | $131.83 | $169.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $87.10 Typical High $112.20 | Professional | 56 · Pre-op care only | $79.43 | $87.10 | $112.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $562.34 Median $616.60 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $562.34 | $616.60 | $794.33 |
Where Florida sits
The same service costs 5.1 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 $14,362HI $2,794
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.