How much rates vary
Facilitymedian $3,467 · 10th to 90th $1,413 to $13,804Professionalmedian $479 · 10th to 90th $81 to $794
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 $616.60 Median $4,365.16 Typical High $12,022.64 | Facility | None | $616.60 | $4,365.16 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $501.19 Median $549.54 Typical High $794.33 | Professional | None | $501.19 | $549.54 | $794.33 |
Ambetter Setting Professional Modifier None Typical Low $38.90 Median $288.40 Typical High $575.44 | Professional | None | $38.90 | $288.40 | $575.44 |
AvMed Setting Facility Modifier None Typical Low $512.86 Median $2,137.96 Typical High $9,772.37 | Facility | None | $512.86 | $2,137.96 | $9,772.37 |
AvMed Setting Professional Modifier None Typical Low $489.78 Median $645.65 Typical High $707.95 | Professional | None | $489.78 | $645.65 | $707.95 |
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 $457.09 Median $478.63 Typical High $954.99 | Professional | None | $457.09 | $478.63 | $954.99 |
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 $251.19 Median $562.34 Typical High $758.58 | Professional | None | $251.19 | $562.34 | $758.58 |
Molina Setting Professional Modifier None Typical Low $60.26 Median $380.19 Typical High $741.31 | Professional | None | $60.26 | $380.19 | $741.31 |
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 $416.87 Median $537.03 Typical High $1,047.13 | Professional | None | $416.87 | $537.03 | $1,047.13 |
Wellpoint Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $602.56 | Professional | None | $467.74 | $467.74 | $602.56 |
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 $245.47 Median $275.42 Typical High $331.13 | Professional | 52 · Reduced service | $245.47 | $275.42 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $109.65 Typical High $131.83 | Professional | 53 · Discontinued | $100.00 | $109.65 | $131.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $416.87 Typical High $501.19 | Professional | 54 · Surgery only | $371.54 | $416.87 | $501.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $83.18 Typical High $100.00 | Professional | 55 · Aftercare only | $74.13 | $83.18 | $100.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $54.95 Typical High $66.07 | Professional | 56 · Pre-op care only | $50.12 | $54.95 | $66.07 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $346.74 Median $389.05 Typical High $467.74 | Professional | 78 · Unplanned return to OR | $346.74 | $389.05 | $467.74 |
Where Florida sits
The same service costs 6.8 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 $13,753MT $2,023
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.