How much rates vary
Facilitymedian $4,677 · 10th to 90th $1,479 to $13,490Professionalmedian $562 · 10th to 90th $87 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 $645.65 Median $4,365.16 Typical High $12,022.64 | Facility | None | $645.65 | $4,365.16 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $616.60 Median $676.08 Typical High $891.25 | Professional | None | $616.60 | $676.08 | $891.25 |
Ambetter Setting Professional Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,318.26 | Professional | None | $1,318.26 | $1,318.26 | $1,318.26 |
AvMed Setting Facility Modifier None Typical Low $588.84 Median $2,137.96 Typical High $9,772.37 | Facility | None | $588.84 | $2,137.96 | $9,772.37 |
AvMed Setting Professional Modifier None Typical Low $562.34 Median $741.31 Typical High $870.96 | Professional | None | $562.34 | $741.31 | $870.96 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $4,570.88 Typical High $8,511.38 | Facility | None | $501.19 | $4,570.88 | $8,511.38 |
Cigna Setting Professional Modifier None Typical Low $549.54 Median $575.44 Typical High $1,174.90 | Professional | None | $549.54 | $575.44 | $1,174.90 |
Florida Blue Setting Facility Modifier None Typical Low $2,818.38 Median $5,495.41 Typical High $16,982.44 | Facility | None | $2,818.38 | $5,495.41 | $16,982.44 |
Florida Blue Setting Professional Modifier None Typical Low $316.23 Median $660.69 Typical High $870.96 | Professional | None | $316.23 | $660.69 | $870.96 |
Molina Setting Professional Modifier None Typical Low $60.26 Median $436.52 Typical High $812.83 | Professional | None | $60.26 | $436.52 | $812.83 |
United Setting Facility Modifier None Typical Low $1,584.89 Median $4,073.80 Typical High $15,488.17 | Facility | None | $1,584.89 | $4,073.80 | $15,488.17 |
United Setting Professional Modifier None Typical Low $512.86 Median $660.69 Typical High $1,288.25 | Professional | None | $512.86 | $660.69 | $1,288.25 |
Wellpoint Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $691.83 | Professional | None | $524.81 | $524.81 | $691.83 |
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 $309.03 Median $338.84 Typical High $398.11 | Professional | 52 · Reduced service | $309.03 | $338.84 | $398.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $134.90 Typical High $158.49 | Professional | 53 · Discontinued | $123.03 | $134.90 | $158.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $501.19 Typical High $602.56 | Professional | 54 · Surgery only | $457.09 | $501.19 | $602.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $100.00 Typical High $120.23 | Professional | 55 · Aftercare only | $91.20 | $100.00 | $120.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $67.61 Typical High $79.43 | Professional | 56 · Pre-op care only | $61.66 | $67.61 | $79.43 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $467.74 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $426.58 | $467.74 | $562.34 |
Where Florida sits
The same service costs 6.0 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 $14,230MT $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.