How much rates vary
Facilitymedian $209 · 10th to 90th $100 to $437Professionalmedian $331 · 10th to 90th $251 to $437
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 $302.00 Median $1,071.52 Typical High $2,454.71 | Facility | None | $302.00 | $1,071.52 | $2,454.71 |
Aetna Setting Professional Modifier None Typical Low $251.19 Median $302.00 Typical High $363.08 | Professional | None | $251.19 | $302.00 | $363.08 |
Ambetter Setting Professional Modifier None Typical Low $426.58 Median $426.58 Typical High $426.58 | Professional | None | $426.58 | $426.58 | $426.58 |
BCBS Setting Facility Modifier None Typical Low $125.89 Median $208.93 Typical High $288.40 | Facility | None | $125.89 | $208.93 | $288.40 |
BCBS Setting Professional Modifier None Typical Low $288.40 Median $316.23 Typical High $416.87 | Professional | None | $288.40 | $316.23 | $416.87 |
Cigna Setting Facility Modifier None Typical Low $107.15 Median $128.82 Typical High $165.96 | Facility | None | $107.15 | $128.82 | $165.96 |
Cigna Setting Professional Modifier None Typical Low $218.78 Median $407.38 Typical High $446.68 | Professional | None | $218.78 | $407.38 | $446.68 |
Qualchoice Setting Professional Modifier None Typical Low $489.78 Median $489.78 Typical High $489.78 | Professional | None | $489.78 | $489.78 | $489.78 |
United Setting Facility Modifier None Typical Low $79.43 Median $131.83 Typical High $707.95 | Facility | None | $79.43 | $131.83 | $707.95 |
United Setting Professional Modifier None Typical Low $218.78 Median $281.84 Typical High $512.86 | Professional | None | $218.78 | $281.84 | $512.86 |
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 $131.83 Median $151.36 Typical High $165.96 | Professional | 52 · Reduced service | $131.83 | $151.36 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $53.70 Median $60.26 Typical High $66.07 | Professional | 53 · Discontinued | $53.70 | $60.26 | $66.07 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $199.53 Median $229.09 Typical High $245.47 | Professional | 54 · Surgery only | $199.53 | $229.09 | $245.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $39.81 Median $45.71 Typical High $48.98 | Professional | 55 · Aftercare only | $39.81 | $45.71 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $30.20 Typical High $33.11 | Professional | 56 · Pre-op care only | $26.92 | $30.20 | $33.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $186.21 Median $213.80 Typical High $229.09 | Professional | 78 · Unplanned return to OR | $186.21 | $213.80 | $229.09 |
Where Arkansas sits
The same service costs 6.4 times more in Colorado than in Florida. 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 $2,602FL $408
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.