How much rates vary
Facilitymedian $2,512 · 10th to 90th $437 to $24,547Professionalmedian $776 · 10th to 90th $81 to $1,479
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 $776.25 Median $4,897.79 Typical High $12,022.64 | Facility | None | $776.25 | $4,897.79 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $794.33 Median $812.83 Typical High $1,548.82 | Professional | None | $794.33 | $812.83 | $1,548.82 |
Ambetter Setting Professional Modifier None Typical Low $109.65 Median $812.83 Typical High $812.83 | Professional | None | $109.65 | $812.83 | $812.83 |
AvMed Setting Facility Modifier None Typical Low $707.95 Median $2,137.96 Typical High $13,182.57 | Facility | None | $707.95 | $2,137.96 | $13,182.57 |
AvMed Setting Professional Modifier None Typical Low $707.95 Median $933.25 Typical High $1,071.52 | Professional | None | $707.95 | $933.25 | $1,071.52 |
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 $630.96 Median $912.01 Typical High $1,819.70 | Professional | None | $630.96 | $912.01 | $1,819.70 |
Florida Blue Setting Facility Modifier None Typical Low $10,000.00 Median $21,877.62 Typical High $33,884.42 | Facility | None | $10,000.00 | $21,877.62 | $33,884.42 |
Florida Blue Setting Professional Modifier None Typical Low $616.60 Median $660.69 Typical High $1,000.00 | Professional | None | $616.60 | $660.69 | $1,000.00 |
Molina Setting Professional Modifier None Typical Low $72.44 Median $676.08 Typical High $1,380.38 | Professional | None | $72.44 | $676.08 | $1,380.38 |
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 $724.44 Median $1,096.48 Typical High $1,995.26 | Professional | None | $724.44 | $1,096.48 | $1,995.26 |
Wellpoint Setting Professional Modifier None Typical Low $645.65 Median $645.65 Typical High $891.25 | Professional | None | $645.65 | $645.65 | $891.25 |
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 $398.11 Median $407.38 Typical High $501.19 | Professional | 52 · Reduced service | $398.11 | $407.38 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $162.18 Typical High $199.53 | Professional | 53 · Discontinued | $158.49 | $162.18 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $602.56 Median $602.56 Typical High $741.31 | Professional | 54 · Surgery only | $602.56 | $602.56 | $741.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $120.23 Typical High $151.36 | Professional | 55 · Aftercare only | $120.23 | $120.23 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $81.28 Typical High $100.00 | Professional | 56 · Pre-op care only | $79.43 | $81.28 | $100.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $562.34 Median $562.34 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $562.34 | $562.34 | $707.95 |
Ambetter Setting Professional Modifier AS · PA/NP assist Typical Low $54.95 Median $54.95 Typical High $54.95 | Professional | AS · PA/NP assist | $54.95 | $54.95 | $54.95 |
Where Florida sits
The same service costs 10.5 times more in Colorado than in Maryland. 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 $15,743MD $1,496
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.