How much rates vary
Facilitymedian $1,660 · 10th to 90th $724 to $11,749Professionalmedian $240 · 10th to 90th $186 to $389
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 $407.38 Median $3,311.31 Typical High $11,481.54 | Facility | None | $407.38 | $3,311.31 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $234.42 Median $251.19 Typical High $331.13 | Professional | None | $234.42 | $251.19 | $331.13 |
Ambetter Setting Professional Modifier None Typical Low $251.19 Median $251.19 Typical High $263.03 | Professional | None | $251.19 | $251.19 | $263.03 |
AvMed Setting Facility Modifier None Typical Low $331.13 Median $1,513.56 Typical High $9,549.93 | Facility | None | $331.13 | $1,513.56 | $9,549.93 |
AvMed Setting Professional Modifier None Typical Low $208.93 Median $281.84 Typical High $331.13 | Professional | None | $208.93 | $281.84 | $331.13 |
Cigna Setting Facility Modifier None Typical Low $323.59 Median $1,659.59 Typical High $2,884.03 | Facility | None | $323.59 | $1,659.59 | $2,884.03 |
Cigna Setting Professional Modifier None Typical Low $194.98 Median $204.17 Typical High $436.52 | Professional | None | $194.98 | $204.17 | $436.52 |
Florida Blue Setting Facility Modifier None Typical Low $870.96 Median $1,737.80 Typical High $16,982.44 | Facility | None | $870.96 | $1,737.80 | $16,982.44 |
Florida Blue Setting Professional Modifier None Typical Low $120.23 Median $251.19 Typical High $549.54 | Professional | None | $120.23 | $251.19 | $549.54 |
Molina Setting Professional Modifier None Typical Low $169.82 Median $239.88 Typical High $389.05 | Professional | None | $169.82 | $239.88 | $389.05 |
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 $186.21 Median $245.47 Typical High $467.74 | Professional | None | $186.21 | $245.47 | $467.74 |
Wellpoint Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $263.03 | Professional | None | $199.53 | $199.53 | $263.03 |
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 $125.89 Typical High $151.36 | Professional | 52 · Reduced service | $117.49 | $125.89 | $151.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $47.86 Median $50.12 Typical High $60.26 | Professional | 53 · Discontinued | $47.86 | $50.12 | $60.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $177.83 Median $186.21 Typical High $229.09 | Professional | 54 · Surgery only | $177.83 | $186.21 | $229.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $37.15 Typical High $45.71 | Professional | 55 · Aftercare only | $35.48 | $37.15 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $25.12 Typical High $30.20 | Professional | 56 · Pre-op care only | $23.99 | $25.12 | $30.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $165.96 Median $173.78 Typical High $213.80 | Professional | 78 · Unplanned return to OR | $165.96 | $173.78 | $213.80 |
Where Florida sits
The same service costs 7.3 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 $6,269MT $863
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.