How much rates vary
Facilitymedian $1,318 · 10th to 90th $501 to $6,026Professionalmedian $257 · 10th to 90th $76 to $417
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 $549.54 Median $3,715.35 Typical High $11,481.54 | Facility | None | $549.54 | $3,715.35 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $234.42 Median $275.42 Typical High $354.81 | Professional | None | $234.42 | $275.42 | $354.81 |
AvMed Setting Facility Modifier None Typical Low $446.68 Median $1,584.89 Typical High $9,549.93 | Facility | None | $446.68 | $1,584.89 | $9,549.93 |
AvMed Setting Professional Modifier None Typical Low $251.19 Median $316.23 Typical High $354.81 | Professional | None | $251.19 | $316.23 | $354.81 |
Cigna Setting Facility Modifier None Typical Low $436.52 Median $1,023.29 Typical High $2,187.76 | Facility | None | $436.52 | $1,023.29 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $234.42 Median $245.47 Typical High $478.63 | Professional | None | $234.42 | $245.47 | $478.63 |
Florida Blue Setting Facility Modifier None Typical Low $616.60 Median $1,348.96 Typical High $6,309.57 | Facility | None | $616.60 | $1,348.96 | $6,309.57 |
Florida Blue Setting Professional Modifier None Typical Low $120.23 Median $275.42 Typical High $478.63 | Professional | None | $120.23 | $275.42 | $478.63 |
Molina Setting Professional Modifier None Typical Low $54.95 Median $234.42 Typical High $416.87 | Professional | None | $54.95 | $234.42 | $416.87 |
United Setting Facility Modifier None Typical Low $398.11 Median $1,000.00 Typical High $5,623.41 | Facility | None | $398.11 | $1,000.00 | $5,623.41 |
United Setting Professional Modifier None Typical Low $199.53 Median $269.15 Typical High $524.81 | Professional | None | $199.53 | $269.15 | $524.81 |
Wellpoint Setting Professional Modifier None Typical Low $245.47 Median $245.47 Typical High $316.23 | Professional | None | $245.47 | $245.47 | $316.23 |
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 $117.49 Median $138.04 Typical High $173.78 | Professional | 52 · Reduced service | $117.49 | $138.04 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $47.86 Median $54.95 Typical High $69.18 | Professional | 53 · Discontinued | $47.86 | $54.95 | $69.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $177.83 Median $208.93 Typical High $257.04 | Professional | 54 · Surgery only | $177.83 | $208.93 | $257.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $41.69 Typical High $51.29 | Professional | 55 · Aftercare only | $35.48 | $41.69 | $51.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.44 Median $27.54 Typical High $34.67 | Professional | 56 · Pre-op care only | $23.44 | $27.54 | $34.67 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $165.96 Median $194.98 Typical High $239.88 | Professional | 78 · Unplanned return to OR | $165.96 | $194.98 | $239.88 |
Where Florida sits
The same service costs 4.6 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 $4,822MT $1,050
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.