How much rates vary
Facilitymedian $1,122 · 10th to 90th $457 to $6,310Professionalmedian $155 · 10th to 90th $115 to $295
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 $602.56 Median $3,890.45 Typical High $10,964.78 | Facility | None | $602.56 | $3,890.45 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $147.91 Median $154.88 Typical High $208.93 | Professional | None | $147.91 | $154.88 | $208.93 |
AvMed Setting Facility Modifier None Typical Low $446.68 Median $1,584.89 Typical High $9,549.93 | Facility | None | $446.68 | $1,584.89 | $9,549.93 |
AvMed Setting Professional Modifier None Typical Low $128.82 Median $165.96 Typical High $190.55 | Professional | None | $128.82 | $165.96 | $190.55 |
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 $117.49 Median $169.82 Typical High $331.13 | Professional | None | $117.49 | $169.82 | $331.13 |
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 $109.65 Median $117.49 Typical High $208.93 | Professional | None | $109.65 | $117.49 | $208.93 |
Molina Setting Professional Modifier None Typical Low $107.15 Median $144.54 Typical High $281.84 | Professional | None | $107.15 | $144.54 | $281.84 |
United Setting Facility Modifier None Typical Low $398.11 Median $1,000.00 Typical High $6,165.95 | Facility | None | $398.11 | $1,000.00 | $6,165.95 |
United Setting Professional Modifier None Typical Low $60.26 Median $190.55 Typical High $371.54 | Professional | None | $60.26 | $190.55 | $371.54 |
Wellpoint Setting Professional Modifier None Typical Low $117.49 Median $117.49 Typical High $154.88 | Professional | None | $117.49 | $117.49 | $154.88 |
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 $74.13 Median $77.62 Typical High $100.00 | Professional | 52 · Reduced service | $74.13 | $77.62 | $100.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $29.51 Median $30.90 Typical High $39.81 | Professional | 53 · Discontinued | $29.51 | $30.90 | $39.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $109.65 Median $117.49 Typical High $147.91 | Professional | 54 · Surgery only | $109.65 | $117.49 | $147.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $23.44 Typical High $29.51 | Professional | 55 · Aftercare only | $21.88 | $23.44 | $29.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.79 Median $15.49 Typical High $19.95 | Professional | 56 · Pre-op care only | $14.79 | $15.49 | $19.95 |
Where Florida sits
The same service costs 9.2 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 $4,822MT $526
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.