How much rates vary
Facilitymedian $1,698 · 10th to 90th $724 to $9,550Professionalmedian $389 · 10th to 90th $91 to $646
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 $478.63 Median $3,801.89 Typical High $10,964.78 | Facility | None | $478.63 | $3,801.89 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $316.23 Median $407.38 Typical High $602.56 | Professional | None | $316.23 | $407.38 | $602.56 |
Ambetter Setting Professional Modifier None Typical Low $371.54 Median $512.86 Typical High $660.69 | Professional | None | $371.54 | $512.86 | $660.69 |
AvMed Setting Facility Modifier None Typical Low $446.68 Median $1,479.11 Typical High $9,549.93 | Facility | None | $446.68 | $1,479.11 | $9,549.93 |
AvMed Setting Professional Modifier None Typical Low $380.19 Median $457.09 Typical High $588.84 | Professional | None | $380.19 | $457.09 | $588.84 |
Cigna Setting Facility Modifier None Typical Low $436.52 Median $1,445.44 Typical High $2,344.23 | Facility | None | $436.52 | $1,445.44 | $2,344.23 |
Cigna Setting Professional Modifier None Typical Low $281.84 Median $389.05 Typical High $676.08 | Professional | None | $281.84 | $389.05 | $676.08 |
Florida Blue Setting Facility Modifier None Typical Low $831.76 Median $1,819.70 Typical High $11,748.98 | Facility | None | $831.76 | $1,819.70 | $11,748.98 |
Florida Blue Setting Professional Modifier None Typical Low $208.93 Median $478.63 Typical High $676.08 | Professional | None | $208.93 | $478.63 | $676.08 |
Molina Setting Professional Modifier None Typical Low $61.66 Median $363.08 Typical High $630.96 | Professional | None | $61.66 | $363.08 | $630.96 |
United Setting Facility Modifier None Typical Low $794.33 Median $1,778.28 Typical High $7,585.78 | Facility | None | $794.33 | $1,778.28 | $7,585.78 |
United Setting Professional Modifier None Typical Low $275.42 Median $389.05 Typical High $794.33 | Professional | None | $275.42 | $389.05 | $794.33 |
Wellpoint Setting Professional Modifier None Typical Low $288.40 Median $426.58 Typical High $426.58 | Professional | None | $288.40 | $426.58 | $426.58 |
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 $158.49 Median $204.17 Typical High $257.04 | Professional | 52 · Reduced service | $158.49 | $204.17 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $81.28 Typical High $102.33 | Professional | 53 · Discontinued | $63.10 | $81.28 | $102.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $234.42 Median $309.03 Typical High $389.05 | Professional | 54 · Surgery only | $234.42 | $309.03 | $389.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $46.77 Median $61.66 Typical High $77.62 | Professional | 55 · Aftercare only | $46.77 | $61.66 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $40.74 Typical High $51.29 | Professional | 56 · Pre-op care only | $31.62 | $40.74 | $51.29 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $218.78 Median $288.40 Typical High $363.08 | Professional | 78 · Unplanned return to OR | $218.78 | $288.40 | $363.08 |
Where Florida sits
The same service costs 4.7 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 $6,464MT $1,390
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.