How much rates vary
Facilitymedian $1,862 · 10th to 90th $759 to $11,749Professionalmedian $275 · 10th to 90th $83 to $457
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 $537.03 Median $4,365.16 Typical High $11,748.98 | Facility | None | $537.03 | $4,365.16 | $11,748.98 |
Aetna Setting Professional Modifier None Typical Low $208.93 Median $302.00 Typical High $398.11 | Professional | None | $208.93 | $302.00 | $398.11 |
Ambetter Setting Professional Modifier None Typical Low $407.38 Median $407.38 Typical High $407.38 | Professional | None | $407.38 | $407.38 | $407.38 |
AvMed Setting Facility Modifier None Typical Low $407.38 Median $1,905.46 Typical High $9,549.93 | Facility | None | $407.38 | $1,905.46 | $9,549.93 |
AvMed Setting Professional Modifier None Typical Low $263.03 Median $331.13 Typical High $426.58 | Professional | None | $263.03 | $331.13 | $426.58 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $1,905.46 Typical High $2,884.03 | Facility | None | $501.19 | $1,905.46 | $2,884.03 |
Cigna Setting Professional Modifier None Typical Low $186.21 Median $275.42 Typical High $501.19 | Professional | None | $186.21 | $275.42 | $501.19 |
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 $151.36 Median $338.84 Typical High $426.58 | Professional | None | $151.36 | $338.84 | $426.58 |
Molina Setting Professional Modifier None Typical Low $31.62 Median $234.42 Typical High $446.68 | Professional | None | $31.62 | $234.42 | $446.68 |
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 $186.21 Median $295.12 Typical High $562.34 | Professional | None | $186.21 | $295.12 | $562.34 |
Wellpoint Setting Professional Modifier None Typical Low $194.98 Median $309.03 Typical High $309.03 | Professional | None | $194.98 | $309.03 | $309.03 |
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 $104.71 Median $147.91 Typical High $194.98 | Professional | 52 · Reduced service | $104.71 | $147.91 | $194.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $42.66 Median $60.26 Typical High $77.62 | Professional | 53 · Discontinued | $42.66 | $60.26 | $77.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $158.49 Median $223.87 Typical High $295.12 | Professional | 54 · Surgery only | $158.49 | $223.87 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $44.67 Typical High $58.88 | Professional | 55 · Aftercare only | $31.62 | $44.67 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $30.20 Typical High $38.90 | Professional | 56 · Pre-op care only | $20.89 | $30.20 | $38.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $147.91 Median $208.93 Typical High $275.42 | Professional | 78 · Unplanned return to OR | $147.91 | $208.93 | $275.42 |
Where Florida sits
The same service costs 6.3 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 $6,296MT $1,002
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.