How much rates vary
Facilitymedian $3,467 · 10th to 90th $1,413 to $13,804Professionalmedian $513 · 10th to 90th $89 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 $4,677.35 Typical High $12,022.64 | Facility | None | $602.56 | $4,677.35 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $537.03 Median $588.84 Typical High $851.14 | Professional | None | $537.03 | $588.84 | $851.14 |
Ambetter Setting Professional Modifier None Typical Low $616.60 Median $851.14 Typical High $912.01 | Professional | None | $616.60 | $851.14 | $912.01 |
AvMed Setting Facility Modifier None Typical Low $549.54 Median $2,137.96 Typical High $9,772.37 | Facility | None | $549.54 | $2,137.96 | $9,772.37 |
AvMed Setting Professional Modifier None Typical Low $524.81 Median $691.83 Typical High $758.58 | Professional | None | $524.81 | $691.83 | $758.58 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $4,365.16 Typical High $8,317.64 | Facility | None | $501.19 | $4,365.16 | $8,317.64 |
Cigna Setting Professional Modifier None Typical Low $489.78 Median $512.86 Typical High $1,047.13 | Professional | None | $489.78 | $512.86 | $1,047.13 |
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 $269.15 Median $588.84 Typical High $758.58 | Professional | None | $269.15 | $588.84 | $758.58 |
Molina Setting Professional Modifier None Typical Low $60.26 Median $407.38 Typical High $794.33 | Professional | None | $60.26 | $407.38 | $794.33 |
United Setting Facility Modifier None Typical Low $1,584.89 Median $4,073.80 Typical High $15,488.17 | Facility | None | $1,584.89 | $4,073.80 | $15,488.17 |
United Setting Professional Modifier None Typical Low $446.68 Median $575.44 Typical High $1,122.02 | Professional | None | $446.68 | $575.44 | $1,122.02 |
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 $269.15 Median $295.12 Typical High $354.81 | Professional | 52 · Reduced service | $269.15 | $295.12 | $354.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $117.49 Typical High $141.25 | Professional | 53 · Discontinued | $107.15 | $117.49 | $141.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $398.11 Median $446.68 Typical High $537.03 | Professional | 54 · Surgery only | $398.11 | $446.68 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $89.13 Typical High $107.15 | Professional | 55 · Aftercare only | $79.43 | $89.13 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $58.88 Typical High $70.79 | Professional | 56 · Pre-op care only | $53.70 | $58.88 | $70.79 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $371.54 Median $416.87 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $371.54 | $416.87 | $501.19 |
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 $13,816MT $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.