How much rates vary
Facilitymedian $4,365 · 10th to 90th $1,514 to $14,454Professionalmedian $427 · 10th to 90th $76 to $692
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 $660.69 Median $5,495.41 Typical High $12,589.25 | Facility | None | $660.69 | $5,495.41 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $436.52 Median $478.63 Typical High $616.60 | Professional | None | $436.52 | $478.63 | $616.60 |
AvMed Setting Facility Modifier None Typical Low $501.19 Median $2,137.96 Typical High $9,772.37 | Facility | None | $501.19 | $2,137.96 | $9,772.37 |
AvMed Setting Professional Modifier None Typical Low $426.58 Median $549.54 Typical High $616.60 | Professional | None | $426.58 | $549.54 | $616.60 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $3,981.07 Typical High $11,481.54 | Facility | None | $512.86 | $3,981.07 | $11,481.54 |
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 $2,630.27 Median $5,495.41 Typical High $16,982.44 | Facility | None | $2,630.27 | $5,495.41 | $16,982.44 |
Florida Blue Setting Professional Modifier None Typical Low $223.87 Median $489.78 Typical High $691.83 | Professional | None | $223.87 | $489.78 | $691.83 |
Molina Setting Professional Modifier None Typical Low $57.54 Median $380.19 Typical High $645.65 | Professional | None | $57.54 | $380.19 | $645.65 |
United Setting Facility Modifier None Typical Low $1,584.89 Median $4,073.80 Typical High $15,488.17 | Facility | None | $1,584.89 | $4,073.80 | $15,488.17 |
United Setting Professional Modifier None Typical Low $363.08 Median $467.74 Typical High $912.01 | Professional | None | $363.08 | $467.74 | $912.01 |
Wellpoint Setting Professional Modifier None Typical Low $398.11 Median $398.11 Typical High $537.03 | Professional | None | $398.11 | $398.11 | $537.03 |
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 $218.78 Median $239.88 Typical High $288.40 | Professional | 52 · Reduced service | $218.78 | $239.88 | $288.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $87.10 Median $95.50 Typical High $114.82 | Professional | 53 · Discontinued | $87.10 | $95.50 | $114.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $331.13 Median $363.08 Typical High $436.52 | Professional | 54 · Surgery only | $331.13 | $363.08 | $436.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $72.44 Typical High $87.10 | Professional | 55 · Aftercare only | $66.07 | $72.44 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $47.86 Typical High $57.54 | Professional | 56 · Pre-op care only | $43.65 | $47.86 | $57.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $309.03 Median $338.84 Typical High $407.38 | Professional | 78 · Unplanned return to OR | $309.03 | $338.84 | $407.38 |
Where Florida sits
The same service costs 7.9 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 $13,941MT $1,762
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.