How much rates vary
Facilitymedian $3,467 · 10th to 90th $1,413 to $13,490Professionalmedian $661 · 10th to 90th $95 to $1,072
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 $691.83 Median $3,890.45 Typical High $12,022.64 | Facility | None | $691.83 | $3,890.45 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $691.83 Median $758.58 Typical High $1,096.48 | Professional | None | $691.83 | $758.58 | $1,096.48 |
Ambetter Setting Professional Modifier None Typical Low $109.65 Median $794.33 Typical High $912.01 | Professional | None | $109.65 | $794.33 | $912.01 |
AvMed Setting Facility Modifier None Typical Low $676.08 Median $2,137.96 Typical High $9,772.37 | Facility | None | $676.08 | $2,137.96 | $9,772.37 |
AvMed Setting Professional Modifier None Typical Low $676.08 Median $870.96 Typical High $977.24 | Professional | None | $676.08 | $870.96 | $977.24 |
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 $630.96 Median $660.69 Typical High $1,348.96 | Professional | None | $630.96 | $660.69 | $1,348.96 |
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 $346.74 Median $776.25 Typical High $912.01 | Professional | None | $346.74 | $776.25 | $912.01 |
Molina Setting Professional Modifier None Typical Low $60.26 Median $537.03 Typical High $1,000.00 | Professional | None | $60.26 | $537.03 | $1,000.00 |
United Setting Facility Modifier None Typical Low $1,584.89 Median $4,168.69 Typical High $15,488.17 | Facility | None | $1,584.89 | $4,168.69 | $15,488.17 |
United Setting Professional Modifier None Typical Low $575.44 Median $741.31 Typical High $1,445.44 | Professional | None | $575.44 | $741.31 | $1,445.44 |
Wellpoint Setting Professional Modifier None Typical Low $645.65 Median $645.65 Typical High $851.14 | Professional | None | $645.65 | $645.65 | $851.14 |
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 $338.84 Median $380.19 Typical High $457.09 | Professional | 52 · Reduced service | $338.84 | $380.19 | $457.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $151.36 Typical High $186.21 | Professional | 53 · Discontinued | $138.04 | $151.36 | $186.21 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $575.44 Typical High $691.83 | Professional | 54 · Surgery only | $512.86 | $575.44 | $691.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $114.82 Typical High $138.04 | Professional | 55 · Aftercare only | $102.33 | $114.82 | $138.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $75.86 Typical High $91.20 | Professional | 56 · Pre-op care only | $69.18 | $75.86 | $91.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $537.03 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $478.63 | $537.03 | $645.65 |
Where Florida sits
The same service costs 5.5 times more in Colorado than in Hawaii. 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 $14,085HI $2,567
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.