How much rates vary
Facilitymedian $174 · 10th to 90th $66 to $3,548Professionalmedian $234 · 10th to 90th $58 to $407
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 $218.78 Median $2,818.38 Typical High $12,022.64 | Facility | None | $218.78 | $2,818.38 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $190.55 Median $234.42 Typical High $354.81 | Professional | None | $190.55 | $234.42 | $354.81 |
Ambetter Setting Professional Modifier None Typical Low $245.47 Median $331.13 Typical High $707.95 | Professional | None | $245.47 | $331.13 | $707.95 |
AvMed Setting Facility Modifier None Typical Low $257.04 Median $2,137.96 Typical High $11,748.98 | Facility | None | $257.04 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $229.09 Median $309.03 Typical High $380.19 | Professional | None | $229.09 | $309.03 | $380.19 |
Cigna Setting Facility Modifier None Typical Low $52.48 Median $147.91 Typical High $295.12 | Facility | None | $52.48 | $147.91 | $295.12 |
Cigna Setting Professional Modifier None Typical Low $190.55 Median $223.87 Typical High $398.11 | Professional | None | $190.55 | $223.87 | $398.11 |
Florida Blue Setting Facility Modifier None Typical Low $64.57 Median $131.83 Typical High $3,019.95 | Facility | None | $64.57 | $131.83 | $3,019.95 |
Florida Blue Setting Professional Modifier None Typical Low $104.71 Median $257.04 Typical High $389.05 | Professional | None | $104.71 | $257.04 | $389.05 |
Molina Setting Professional Modifier None Typical Low $31.62 Median $234.42 Typical High $436.52 | Professional | None | $31.62 | $234.42 | $436.52 |
United Setting Facility Modifier None Typical Low $81.28 Median $302.00 Typical High $2,818.38 | Facility | None | $81.28 | $302.00 | $2,818.38 |
United Setting Professional Modifier None Typical Low $169.82 Median $229.09 Typical High $446.68 | Professional | None | $169.82 | $229.09 | $446.68 |
Wellpoint Setting Professional Modifier None Typical Low $234.42 Median $257.04 Typical High $257.04 | Professional | None | $234.42 | $257.04 | $257.04 |
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 $95.50 Median $112.20 Typical High $147.91 | Professional | 52 · Reduced service | $95.50 | $112.20 | $147.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $44.67 Typical High $58.88 | Professional | 53 · Discontinued | $38.02 | $44.67 | $58.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $144.54 Median $165.96 Typical High $218.78 | Professional | 54 · Surgery only | $144.54 | $165.96 | $218.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $33.11 Typical High $44.67 | Professional | 55 · Aftercare only | $28.84 | $33.11 | $44.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $22.39 Typical High $29.51 | Professional | 56 · Pre-op care only | $19.05 | $22.39 | $29.51 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $134.90 Median $154.88 Typical High $204.17 | Professional | 78 · Unplanned return to OR | $134.90 | $154.88 | $204.17 |
Where Florida 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.