How much rates vary
Facilitymedian $1,096 · 10th to 90th $447 to $6,026Professionalmedian $224 · 10th to 90th $115 to $437
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 $194.98 Median $2,344.23 Typical High $10,000.00 | Facility | None | $194.98 | $2,344.23 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $120.23 Median $218.78 Typical High $398.11 | Professional | None | $120.23 | $218.78 | $398.11 |
Ambetter Setting Professional Modifier None Typical Low $117.49 Median $120.23 Typical High $239.88 | Professional | None | $117.49 | $120.23 | $239.88 |
AvMed Setting Facility Modifier None Typical Low $309.03 Median $1,479.11 Typical High $9,549.93 | Facility | None | $309.03 | $1,479.11 | $9,549.93 |
AvMed Setting Professional Modifier None Typical Low $134.90 Median $234.42 Typical High $316.23 | Professional | None | $134.90 | $234.42 | $316.23 |
Cigna Setting Facility Modifier None Typical Low $436.52 Median $977.24 Typical High $2,187.76 | Facility | None | $436.52 | $977.24 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $97.72 Median $186.21 Typical High $416.87 | Professional | None | $97.72 | $186.21 | $416.87 |
Florida Blue Setting Facility Modifier None Typical Low $501.19 Median $1,071.52 Typical High $6,309.57 | Facility | None | $501.19 | $1,071.52 | $6,309.57 |
Florida Blue Setting Professional Modifier None Typical Low $199.53 Median $213.80 Typical High $302.00 | Professional | None | $199.53 | $213.80 | $302.00 |
Molina Setting Professional Modifier None Typical Low $213.80 Median $316.23 Typical High $630.96 | Professional | None | $213.80 | $316.23 | $630.96 |
United Setting Facility Modifier None Typical Low $398.11 Median $1,000.00 Typical High $5,623.41 | Facility | None | $398.11 | $1,000.00 | $5,623.41 |
United Setting Professional Modifier None Typical Low $109.65 Median $223.87 Typical High $478.63 | Professional | None | $109.65 | $223.87 | $478.63 |
Wellpoint Setting Professional Modifier None Typical Low $93.33 Median $213.80 Typical High $213.80 | Professional | None | $93.33 | $213.80 | $213.80 |
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 $60.26 Median $102.33 Typical High $131.83 | Professional | 52 · Reduced service | $60.26 | $102.33 | $131.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.99 Median $40.74 Typical High $52.48 | Professional | 53 · Discontinued | $23.99 | $40.74 | $52.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $89.13 Median $154.88 Typical High $199.53 | Professional | 54 · Surgery only | $89.13 | $154.88 | $199.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $30.90 Typical High $39.81 | Professional | 55 · Aftercare only | $17.78 | $30.90 | $39.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $20.42 Typical High $26.30 | Professional | 56 · Pre-op care only | $12.02 | $20.42 | $26.30 |
Ambetter Setting Professional Modifier 52 · Reduced service Typical Low $34.67 Median $40.74 Typical High $87.10 | Professional | 52 · Reduced service | $34.67 | $40.74 | $87.10 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $112.20 Median $112.20 Typical High $138.04 | Professional | 59 · Distinct service | $112.20 | $112.20 | $138.04 |
Where Florida sits
The same service costs 8.2 times more in Colorado than in West Virginia. 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 $4,192WV $514
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.