How much rates vary
Facilitymedian $3,467 · 10th to 90th $1,413 to $13,490Professionalmedian $417 · 10th to 90th $93 to $676
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 $5,495.41 Typical High $12,022.64 | Facility | None | $645.65 | $5,495.41 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $426.58 Median $467.74 Typical High $660.69 | Professional | None | $426.58 | $467.74 | $660.69 |
Ambetter Setting Professional Modifier None Typical Low $288.40 Median $524.81 Typical High $575.44 | Professional | None | $288.40 | $524.81 | $575.44 |
AvMed Setting Facility Modifier None Typical Low $562.34 Median $2,137.96 Typical High $9,772.37 | Facility | None | $562.34 | $2,137.96 | $9,772.37 |
AvMed Setting Professional Modifier None Typical Low $436.52 Median $549.54 Typical High $602.56 | Professional | None | $436.52 | $549.54 | $602.56 |
Cigna Setting Facility Modifier None Typical Low $616.60 Median $4,466.84 Typical High $8,511.38 | Facility | None | $616.60 | $4,466.84 | $8,511.38 |
Cigna Setting Professional Modifier None Typical Low $398.11 Median $416.87 Typical High $831.76 | Professional | None | $398.11 | $416.87 | $831.76 |
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 $213.80 Median $467.74 Typical High $588.84 | Professional | None | $213.80 | $467.74 | $588.84 |
Molina Setting Professional Modifier None Typical Low $60.26 Median $346.74 Typical High $630.96 | Professional | None | $60.26 | $346.74 | $630.96 |
United Setting Facility Modifier None Typical Low $1,584.89 Median $4,265.80 Typical High $15,488.17 | Facility | None | $1,584.89 | $4,265.80 | $15,488.17 |
United Setting Professional Modifier None Typical Low $354.81 Median $457.09 Typical High $912.01 | Professional | None | $354.81 | $457.09 | $912.01 |
Wellpoint Setting Professional Modifier None Typical Low $416.87 Median $416.87 Typical High $549.54 | Professional | None | $416.87 | $416.87 | $549.54 |
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 $213.80 Median $234.42 Typical High $295.12 | Professional | 52 · Reduced service | $213.80 | $234.42 | $295.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $85.11 Median $93.33 Typical High $117.49 | Professional | 53 · Discontinued | $85.11 | $93.33 | $117.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $354.81 Typical High $446.68 | Professional | 54 · Surgery only | $316.23 | $354.81 | $446.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $70.79 Typical High $89.13 | Professional | 55 · Aftercare only | $63.10 | $70.79 | $89.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $42.66 Median $46.77 Typical High $58.88 | Professional | 56 · Pre-op care only | $42.66 | $46.77 | $58.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $295.12 Median $331.13 Typical High $416.87 | Professional | 78 · Unplanned return to OR | $295.12 | $331.13 | $416.87 |
Where Florida sits
The same service costs 7.5 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 $13,659MT $1,825
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.