How much rates vary
Facilitymedian $4,571 · 10th to 90th $1,738 to $14,454Professionalmedian $813 · 10th to 90th $132 to $1,318
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 $891.25 Median $5,495.41 Typical High $13,489.63 | Facility | None | $891.25 | $5,495.41 | $13,489.63 |
Aetna Setting Professional Modifier None Typical Low $891.25 Median $933.25 Typical High $1,479.11 | Professional | None | $891.25 | $933.25 | $1,479.11 |
Ambetter Setting Professional Modifier None Typical Low $131.83 Median $954.99 Typical High $1,202.26 | Professional | None | $131.83 | $954.99 | $1,202.26 |
AvMed Setting Facility Modifier None Typical Low $724.44 Median $2,454.71 Typical High $10,715.19 | Facility | None | $724.44 | $2,454.71 | $10,715.19 |
AvMed Setting Professional Modifier None Typical Low $812.83 Median $1,071.52 Typical High $1,258.93 | Professional | None | $812.83 | $1,071.52 | $1,258.93 |
Cigna Setting Facility Modifier None Typical Low $724.44 Median $3,801.89 Typical High $11,481.54 | Facility | None | $724.44 | $3,801.89 | $11,481.54 |
Cigna Setting Professional Modifier None Typical Low $776.25 Median $812.83 Typical High $1,659.59 | Professional | None | $776.25 | $812.83 | $1,659.59 |
Florida Blue Setting Facility Modifier None Typical Low $2,630.27 Median $5,623.41 Typical High $16,982.44 | Facility | None | $2,630.27 | $5,623.41 | $16,982.44 |
Florida Blue Setting Professional Modifier None Typical Low $457.09 Median $954.99 Typical High $1,148.15 | Professional | None | $457.09 | $954.99 | $1,148.15 |
Molina Setting Professional Modifier None Typical Low $91.20 Median $630.96 Typical High $1,148.15 | Professional | None | $91.20 | $630.96 | $1,148.15 |
United Setting Facility Modifier None Typical Low $1,659.59 Median $4,265.80 Typical High $15,488.17 | Facility | None | $1,659.59 | $4,265.80 | $15,488.17 |
United Setting Professional Modifier None Typical Low $724.44 Median $933.25 Typical High $1,819.70 | Professional | None | $724.44 | $933.25 | $1,819.70 |
Wellpoint Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $1,000.00 | Professional | None | $758.58 | $758.58 | $1,000.00 |
7 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 $446.68 Median $467.74 Typical High $562.34 | Professional | 52 · Reduced service | $446.68 | $467.74 | $562.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $186.21 Typical High $223.87 | Professional | 53 · Discontinued | $177.83 | $186.21 | $223.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $707.95 Typical High $851.14 | Professional | 54 · Surgery only | $660.69 | $707.95 | $851.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $141.25 Typical High $169.82 | Professional | 55 · Aftercare only | $131.83 | $141.25 | $169.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $93.33 Typical High $112.20 | Professional | 56 · Pre-op care only | $89.13 | $93.33 | $112.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $660.69 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $616.60 | $660.69 | $794.33 |
Ambetter Setting Professional Modifier 22 · Increased work Typical Low $776.25 Median $776.25 Typical High $776.25 | Professional | 22 · Increased work | $776.25 | $776.25 | $776.25 |
Where Florida sits
The same service costs 4.2 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 $14,362MT $3,396
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.