How much rates vary
Facilitymedian $1,862 · 10th to 90th $759 to $11,749Professionalmedian $380 · 10th to 90th $83 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 $524.81 Median $3,801.89 Typical High $11,481.54 | Facility | None | $524.81 | $3,801.89 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $295.12 Median $407.38 Typical High $575.44 | Professional | None | $295.12 | $407.38 | $575.44 |
Ambetter Setting Professional Modifier None Typical Low $478.63 Median $478.63 Typical High $478.63 | Professional | None | $478.63 | $478.63 | $478.63 |
AvMed Setting Facility Modifier None Typical Low $501.19 Median $1,905.46 Typical High $9,549.93 | Facility | None | $501.19 | $1,905.46 | $9,549.93 |
AvMed Setting Professional Modifier None Typical Low $363.08 Median $478.63 Typical High $602.56 | Professional | None | $363.08 | $478.63 | $602.56 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $1,905.46 Typical High $2,884.03 | Facility | None | $501.19 | $1,905.46 | $2,884.03 |
Cigna Setting Professional Modifier None Typical Low $251.19 Median $371.54 Typical High $676.08 | Professional | None | $251.19 | $371.54 | $676.08 |
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 $208.93 Median $467.74 Typical High $602.56 | Professional | None | $208.93 | $467.74 | $602.56 |
Molina Setting Professional Modifier None Typical Low $31.62 Median $346.74 Typical High $660.69 | Professional | None | $31.62 | $346.74 | $660.69 |
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 $257.04 Median $389.05 Typical High $758.58 | Professional | None | $257.04 | $389.05 | $758.58 |
Wellpoint Setting Professional Modifier None Typical Low $269.15 Median $436.52 Typical High $436.52 | Professional | None | $269.15 | $436.52 | $436.52 |
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 $147.91 Median $204.17 Typical High $263.03 | Professional | 52 · Reduced service | $147.91 | $204.17 | $263.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $58.88 Median $83.18 Typical High $104.71 | Professional | 53 · Discontinued | $58.88 | $83.18 | $104.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $218.78 Median $309.03 Typical High $398.11 | Professional | 54 · Surgery only | $218.78 | $309.03 | $398.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $44.67 Median $61.66 Typical High $79.43 | Professional | 55 · Aftercare only | $44.67 | $61.66 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $29.51 Median $40.74 Typical High $52.48 | Professional | 56 · Pre-op care only | $29.51 | $40.74 | $52.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $204.17 Median $288.40 Typical High $371.54 | Professional | 78 · Unplanned return to OR | $204.17 | $288.40 | $371.54 |
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 $6,438MT $1,383
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.