How much rates vary
Facilitymedian $309 · 10th to 90th $100 to $1,122Professionalmedian $295 · 10th to 90th $65 to $457
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 $309.03 Median $338.84 Typical High $16,595.87 | Facility | None | $309.03 | $338.84 | $16,595.87 |
Aetna Setting Professional Modifier None Typical Low $257.04 Median $309.03 Typical High $338.84 | Professional | None | $257.04 | $309.03 | $338.84 |
BCBS Setting Facility Modifier None Typical Low $229.09 Median $398.11 Typical High $724.44 | Facility | None | $229.09 | $398.11 | $724.44 |
BCBS Setting Professional Modifier None Typical Low $194.98 Median $288.40 Typical High $338.84 | Professional | None | $194.98 | $288.40 | $338.84 |
Cigna Setting Facility Modifier None Typical Low $75.86 Median $151.36 Typical High $245.47 | Facility | None | $75.86 | $151.36 | $245.47 |
Cigna Setting Professional Modifier None Typical Low $263.03 Median $295.12 Typical High $489.78 | Professional | None | $263.03 | $295.12 | $489.78 |
Medcost Setting Facility Modifier None Typical Low $95.50 Median $204.17 Typical High $416.87 | Facility | None | $95.50 | $204.17 | $416.87 |
Medcost Setting Professional Modifier None Typical Low $275.42 Median $338.84 Typical High $489.78 | Professional | None | $275.42 | $338.84 | $489.78 |
Molina Setting Professional Modifier None Typical Low $38.90 Median $269.15 Typical High $478.63 | Professional | None | $38.90 | $269.15 | $478.63 |
United Setting Facility Modifier None Typical Low $83.18 Median $446.68 Typical High $2,238.72 | Facility | None | $83.18 | $446.68 | $2,238.72 |
United Setting Professional Modifier None Typical Low $213.80 Median $275.42 Typical High $436.52 | Professional | None | $213.80 | $275.42 | $436.52 |
8 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 $141.25 Median $151.36 Typical High $165.96 | Professional | 52 · Reduced service | $141.25 | $151.36 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $61.66 Typical High $67.61 | Professional | 53 · Discontinued | $56.23 | $61.66 | $67.61 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $229.09 Typical High $251.19 | Professional | 54 · Surgery only | $208.93 | $229.09 | $251.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $42.66 Median $45.71 Typical High $50.12 | Professional | 55 · Aftercare only | $42.66 | $45.71 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $30.90 Typical High $33.88 | Professional | 56 · Pre-op care only | $28.18 | $30.90 | $33.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $194.98 Median $213.80 Typical High $234.42 | Professional | 78 · Unplanned return to OR | $194.98 | $213.80 | $234.42 |
Ambetter Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $263.03 Typical High $263.03 | Professional | 54 · Surgery only | $263.03 | $263.03 | $263.03 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $134.90 Median $208.93 Typical High $263.03 | Professional | 51 · Multiple procedures | $134.90 | $208.93 | $263.03 |
Where South Carolina 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.