How much rates vary
Facilitymedian $1,820 · 10th to 90th $741 to $11,749Professionalmedian $372 · 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 $10,964.78 | Facility | None | $524.81 | $3,801.89 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $295.12 Median $416.87 Typical High $549.54 | Professional | None | $295.12 | $416.87 | $549.54 |
AvMed Setting Facility Modifier None Typical Low $446.68 Median $1,621.81 Typical High $9,549.93 | Facility | None | $446.68 | $1,621.81 | $9,549.93 |
AvMed Setting Professional Modifier None Typical Low $338.84 Median $446.68 Typical High $616.60 | Professional | None | $338.84 | $446.68 | $616.60 |
Cigna Setting Facility Modifier None Typical Low $436.52 Median $1,862.09 Typical High $2,951.21 | Facility | None | $436.52 | $1,862.09 | $2,951.21 |
Cigna Setting Professional Modifier None Typical Low $245.47 Median $371.54 Typical High $741.31 | Professional | None | $245.47 | $371.54 | $741.31 |
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 $218.78 Median $478.63 Typical High $588.84 | Professional | None | $218.78 | $478.63 | $588.84 |
Molina Setting Professional Modifier None Typical Low $31.62 Median $309.03 Typical High $630.96 | Professional | None | $31.62 | $309.03 | $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 $269.15 Median $446.68 Typical High $831.76 | Professional | None | $269.15 | $446.68 | $831.76 |
Wellpoint Setting Professional Modifier None Typical Low $251.19 Median $416.87 Typical High $416.87 | Professional | None | $251.19 | $416.87 | $416.87 |
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 $213.80 Typical High $275.42 | Professional | 52 · Reduced service | $147.91 | $213.80 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $58.88 Median $85.11 Typical High $109.65 | Professional | 53 · Discontinued | $58.88 | $85.11 | $109.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $218.78 Median $323.59 Typical High $416.87 | Professional | 54 · Surgery only | $218.78 | $323.59 | $416.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $43.65 Median $64.57 Typical High $83.18 | Professional | 55 · Aftercare only | $43.65 | $64.57 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $29.51 Median $42.66 Typical High $54.95 | Professional | 56 · Pre-op care only | $29.51 | $42.66 | $54.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $204.17 Median $302.00 Typical High $389.05 | Professional | 78 · Unplanned return to OR | $204.17 | $302.00 | $389.05 |
Where Florida sits
The same service costs 4.4 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 $6,451MT $1,460
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.