How much rates vary
Facilitymedian $1,820 · 10th to 90th $741 to $11,749Professionalmedian $339 · 10th to 90th $81 to $575
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 $478.63 Median $3,801.89 Typical High $10,964.78 | Facility | None | $478.63 | $3,801.89 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $263.03 Median $354.81 Typical High $489.78 | Professional | None | $263.03 | $354.81 | $489.78 |
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 $323.59 Median $407.38 Typical High $524.81 | Professional | None | $323.59 | $407.38 | $524.81 |
Cigna Setting Facility Modifier None Typical Low $436.52 Median $1,862.09 Typical High $2,884.03 | Facility | None | $436.52 | $1,862.09 | $2,884.03 |
Cigna Setting Professional Modifier None Typical Low $229.09 Median $338.84 Typical High $602.56 | Professional | None | $229.09 | $338.84 | $602.56 |
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 $177.83 Median $398.11 Typical High $537.03 | Professional | None | $177.83 | $398.11 | $537.03 |
Molina Setting Professional Modifier None Typical Low $31.62 Median $309.03 Typical High $602.56 | Professional | None | $31.62 | $309.03 | $602.56 |
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 $229.09 Median $346.74 Typical High $676.08 | Professional | None | $229.09 | $346.74 | $676.08 |
Wellpoint Setting Professional Modifier None Typical Low $245.47 Median $389.05 Typical High $389.05 | Professional | None | $245.47 | $389.05 | $389.05 |
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 $131.83 Median $177.83 Typical High $234.42 | Professional | 52 · Reduced service | $131.83 | $177.83 | $234.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $52.48 Median $70.79 Typical High $95.50 | Professional | 53 · Discontinued | $52.48 | $70.79 | $95.50 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $194.98 Median $269.15 Typical High $354.81 | Professional | 54 · Surgery only | $194.98 | $269.15 | $354.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $39.81 Median $53.70 Typical High $70.79 | Professional | 55 · Aftercare only | $39.81 | $53.70 | $70.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $35.48 Typical High $46.77 | Professional | 56 · Pre-op care only | $26.30 | $35.48 | $46.77 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $181.97 Median $251.19 Typical High $331.13 | Professional | 78 · Unplanned return to OR | $181.97 | $251.19 | $331.13 |
Where Florida sits
The same service costs 5.3 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 $6,378MT $1,213
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.