How much rates vary
Facilitymedian $3,388 · 10th to 90th $1,349 to $12,882Professionalmedian $513 · 10th to 90th $87 to $851
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 $602.56 Median $4,265.80 Typical High $11,748.98 | Facility | None | $602.56 | $4,265.80 | $11,748.98 |
Aetna Setting Professional Modifier None Typical Low $575.44 Median $588.84 Typical High $794.33 | Professional | None | $575.44 | $588.84 | $794.33 |
Ambetter Setting Professional Modifier None Typical Low $436.52 Median $457.09 Typical High $870.96 | Professional | None | $436.52 | $457.09 | $870.96 |
AvMed Setting Facility Modifier None Typical Low $537.03 Median $2,137.96 Typical High $9,772.37 | Facility | None | $537.03 | $2,137.96 | $9,772.37 |
AvMed Setting Professional Modifier None Typical Low $512.86 Median $707.95 Typical High $812.83 | Professional | None | $512.86 | $707.95 | $812.83 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $4,466.84 Typical High $8,511.38 | Facility | None | $501.19 | $4,466.84 | $8,511.38 |
Cigna Setting Professional Modifier None Typical Low $489.78 Median $512.86 Typical High $1,071.52 | Professional | None | $489.78 | $512.86 | $1,071.52 |
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 $295.12 Median $616.60 Typical High $912.01 | Professional | None | $295.12 | $616.60 | $912.01 |
Molina Setting Professional Modifier None Typical Low $60.26 Median $398.11 Typical High $758.58 | Professional | None | $60.26 | $398.11 | $758.58 |
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 $457.09 Median $602.56 Typical High $1,148.15 | Professional | None | $457.09 | $602.56 | $1,148.15 |
Wellpoint Setting Professional Modifier None Typical Low $489.78 Median $489.78 Typical High $645.65 | Professional | None | $489.78 | $489.78 | $645.65 |
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 $288.40 Median $295.12 Typical High $371.54 | Professional | 52 · Reduced service | $288.40 | $295.12 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $114.82 Median $120.23 Typical High $147.91 | Professional | 53 · Discontinued | $114.82 | $120.23 | $147.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $446.68 Typical High $562.34 | Professional | 54 · Surgery only | $426.58 | $446.68 | $562.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $87.10 Median $89.13 Typical High $112.20 | Professional | 55 · Aftercare only | $87.10 | $89.13 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $58.88 Typical High $74.13 | Professional | 56 · Pre-op care only | $57.54 | $58.88 | $74.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $416.87 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $398.11 | $416.87 | $524.81 |
Where Florida sits
The same service costs 6.4 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 $13,837MT $2,168
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.