How much rates vary
Facilitymedian $3,311 · 10th to 90th $1,349 to $12,882Professionalmedian $562 · 10th to 90th $93 to $912
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 $707.95 Median $5,495.41 Typical High $12,022.64 | Facility | None | $707.95 | $5,495.41 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $602.56 Median $660.69 Typical High $933.25 | Professional | None | $602.56 | $660.69 | $933.25 |
Ambetter Setting Professional Modifier None Typical Low $93.33 Median $676.08 Typical High $724.44 | Professional | None | $93.33 | $676.08 | $724.44 |
AvMed Setting Facility Modifier None Typical Low $630.96 Median $2,137.96 Typical High $9,772.37 | Facility | None | $630.96 | $2,137.96 | $9,772.37 |
AvMed Setting Professional Modifier None Typical Low $575.44 Median $758.58 Typical High $851.14 | Professional | None | $575.44 | $758.58 | $851.14 |
Cigna Setting Facility Modifier None Typical Low $616.60 Median $3,467.37 Typical High $6,606.93 | Facility | None | $616.60 | $3,467.37 | $6,606.93 |
Cigna Setting Professional Modifier None Typical Low $537.03 Median $562.34 Typical High $1,148.15 | Professional | None | $537.03 | $562.34 | $1,148.15 |
Florida Blue Setting Facility Modifier None Typical Low $1,778.28 Median $3,548.13 Typical High $16,982.44 | Facility | None | $1,778.28 | $3,548.13 | $16,982.44 |
Florida Blue Setting Professional Modifier None Typical Low $309.03 Median $660.69 Typical High $831.76 | Professional | None | $309.03 | $660.69 | $831.76 |
Molina Setting Professional Modifier None Typical Low $60.26 Median $436.52 Typical High $831.76 | Professional | None | $60.26 | $436.52 | $831.76 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $3,311.31 Typical High $12,589.25 | Facility | None | $1,230.27 | $3,311.31 | $12,589.25 |
United Setting Professional Modifier None Typical Low $501.19 Median $645.65 Typical High $1,258.93 | Professional | None | $501.19 | $645.65 | $1,258.93 |
Wellpoint Setting Professional Modifier None Typical Low $549.54 Median $549.54 Typical High $724.44 | Professional | None | $549.54 | $549.54 | $724.44 |
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 $302.00 Median $331.13 Typical High $389.05 | Professional | 52 · Reduced service | $302.00 | $331.13 | $389.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $131.83 Typical High $158.49 | Professional | 53 · Discontinued | $120.23 | $131.83 | $158.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $489.78 Typical High $588.84 | Professional | 54 · Surgery only | $457.09 | $489.78 | $588.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $100.00 Typical High $117.49 | Professional | 55 · Aftercare only | $91.20 | $100.00 | $117.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $66.07 Typical High $79.43 | Professional | 56 · Pre-op care only | $60.26 | $66.07 | $79.43 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $457.09 Typical High $549.54 | Professional | 78 · Unplanned return to OR | $426.58 | $457.09 | $549.54 |
Where Florida sits
The same service costs 5.7 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 $13,613MT $2,377
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.