How much rates vary
Facilitymedian $2,138 · 10th to 90th $813 to $11,749Professionalmedian $251 · 10th to 90th $178 to $479
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 $501.19 Median $4,073.80 Typical High $10,964.78 | Facility | None | $501.19 | $4,073.80 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $213.80 Median $223.87 Typical High $446.68 | Professional | None | $213.80 | $223.87 | $446.68 |
Ambetter Setting Professional Modifier None Typical Low $147.91 Median $208.93 Typical High $380.19 | Professional | None | $147.91 | $208.93 | $380.19 |
AvMed Setting Facility Modifier None Typical Low $446.68 Median $1,659.59 Typical High $9,549.93 | Facility | None | $446.68 | $1,659.59 | $9,549.93 |
AvMed Setting Professional Modifier None Typical Low $181.97 Median $245.47 Typical High $281.84 | Professional | None | $181.97 | $245.47 | $281.84 |
Cigna Setting Facility Modifier None Typical Low $436.52 Median $1,905.46 Typical High $3,019.95 | Facility | None | $436.52 | $1,905.46 | $3,019.95 |
Cigna Setting Professional Modifier None Typical Low $177.83 Median $251.19 Typical High $478.63 | Professional | None | $177.83 | $251.19 | $478.63 |
Florida Blue Setting Facility Modifier None Typical Low $1,230.27 Median $2,630.27 Typical High $16,982.44 | Facility | None | $1,230.27 | $2,630.27 | $16,982.44 |
Florida Blue Setting Professional Modifier None Typical Low $154.88 Median $165.96 Typical High $302.00 | Professional | None | $154.88 | $165.96 | $302.00 |
Molina Setting Professional Modifier None Typical Low $199.53 Median $269.15 Typical High $512.86 | Professional | None | $199.53 | $269.15 | $512.86 |
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 $60.26 Median $275.42 Typical High $524.81 | Professional | None | $60.26 | $275.42 | $524.81 |
Wellpoint Setting Professional Modifier None Typical Low $169.82 Median $169.82 Typical High $218.78 | Professional | None | $169.82 | $169.82 | $218.78 |
5 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 $112.20 Typical High $144.54 | Professional | 52 · Reduced service | $104.71 | $112.20 | $144.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $42.66 Median $44.67 Typical High $58.88 | Professional | 53 · Discontinued | $42.66 | $44.67 | $58.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $158.49 Median $169.82 Typical High $218.78 | Professional | 54 · Surgery only | $158.49 | $169.82 | $218.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $33.88 Typical High $43.65 | Professional | 55 · Aftercare only | $31.62 | $33.88 | $43.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.38 Median $22.39 Typical High $28.84 | Professional | 56 · Pre-op care only | $21.38 | $22.39 | $28.84 |
Where Florida sits
The same service costs 8.5 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 $6,252MT $735
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.