How much rates vary
Facilitymedian $2,512 · 10th to 90th $437 to $25,119Professionalmedian $1,202 · 10th to 90th $155 to $2,344
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 $776.25 Median $3,890.45 Typical High $12,022.64 | Facility | None | $776.25 | $3,890.45 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $1,288.25 Median $1,348.96 Typical High $1,737.80 | Professional | None | $1,288.25 | $1,348.96 | $1,737.80 |
Ambetter Setting Professional Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,584.89 | Professional | None | $1,318.26 | $1,318.26 | $1,584.89 |
AvMed Setting Facility Modifier None Typical Low $1,148.15 Median $2,137.96 Typical High $13,182.57 | Facility | None | $1,148.15 | $2,137.96 | $13,182.57 |
AvMed Setting Professional Modifier None Typical Low $1,230.27 Median $1,513.56 Typical High $1,737.80 | Professional | None | $1,230.27 | $1,513.56 | $1,737.80 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $501.19 Typical High $2,691.53 | Facility | None | $398.11 | $501.19 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $1,047.13 Median $1,479.11 Typical High $3,019.95 | Professional | None | $1,047.13 | $1,479.11 | $3,019.95 |
Florida Blue Setting Facility Modifier None Typical Low $10,471.29 Median $22,387.21 Typical High $33,884.42 | Facility | None | $10,471.29 | $22,387.21 | $33,884.42 |
Florida Blue Setting Professional Modifier None Typical Low $1,000.00 Median $1,071.52 Typical High $1,584.89 | Professional | None | $1,000.00 | $1,071.52 | $1,584.89 |
Molina Setting Professional Modifier None Typical Low $147.91 Median $1,071.52 Typical High $2,187.76 | Professional | None | $147.91 | $1,071.52 | $2,187.76 |
United Setting Facility Modifier None Typical Low $371.54 Median $954.99 Typical High $7,585.78 | Facility | None | $371.54 | $954.99 | $7,585.78 |
United Setting Professional Modifier None Typical Low $60.26 Median $1,621.81 Typical High $3,090.30 | Professional | None | $60.26 | $1,621.81 | $3,090.30 |
Wellpoint Setting Professional Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $1,445.44 | Professional | None | $1,047.13 | $1,047.13 | $1,445.44 |
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 $645.65 Median $676.08 Typical High $831.76 | Professional | 52 · Reduced service | $645.65 | $676.08 | $831.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $257.04 Median $269.15 Typical High $331.13 | Professional | 53 · Discontinued | $257.04 | $269.15 | $331.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $977.24 Median $1,000.00 Typical High $1,258.93 | Professional | 54 · Surgery only | $977.24 | $1,000.00 | $1,258.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $199.53 Typical High $251.19 | Professional | 55 · Aftercare only | $194.98 | $199.53 | $251.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $134.90 Typical High $165.96 | Professional | 56 · Pre-op care only | $128.82 | $134.90 | $165.96 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $912.01 Median $933.25 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $912.01 | $933.25 | $1,174.90 |
Where Florida sits
The same service costs 7.8 times more in Colorado than in Washington. 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 $16,544WA $2,120
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.