How much rates vary
Facilitymedian $977 · 10th to 90th $138 to $8,913Professionalmedian $145 · 10th to 90th $63 to $275
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 $109.65 Median $2,238.72 Typical High $10,715.19 | Facility | None | $109.65 | $2,238.72 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $67.61 Median $144.54 Typical High $213.80 | Professional | None | $67.61 | $144.54 | $213.80 |
Ambetter Setting Professional Modifier None Typical Low $50.12 Median $114.82 Typical High $165.96 | Professional | None | $50.12 | $114.82 | $165.96 |
AvMed Setting Facility Modifier None Typical Low $181.97 Median $1,819.70 Typical High $9,772.37 | Facility | None | $181.97 | $1,819.70 | $9,772.37 |
AvMed Setting Professional Modifier None Typical Low $66.07 Median $144.54 Typical High $190.55 | Professional | None | $66.07 | $144.54 | $190.55 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $1,412.54 Typical High $2,454.71 | Facility | None | $457.09 | $1,412.54 | $2,454.71 |
Cigna Setting Professional Modifier None Typical Low $54.95 Median $125.89 Typical High $281.84 | Professional | None | $54.95 | $125.89 | $281.84 |
Florida Blue Setting Facility Modifier None Typical Low $125.89 Median $275.42 Typical High $11,748.98 | Facility | None | $125.89 | $275.42 | $11,748.98 |
Florida Blue Setting Professional Modifier None Typical Low $120.23 Median $128.82 Typical High $177.83 | Professional | None | $120.23 | $128.82 | $177.83 |
Molina Setting Professional Modifier None Typical Low $134.90 Median $186.21 Typical High $354.81 | Professional | None | $134.90 | $186.21 | $354.81 |
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 $69.18 Median $144.54 Typical High $288.40 | Professional | None | $69.18 | $144.54 | $288.40 |
Wellpoint Setting Professional Modifier None Typical Low $51.29 Median $138.04 Typical High $138.04 | Professional | None | $51.29 | $138.04 | $138.04 |
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 $33.88 Median $67.61 Typical High $85.11 | Professional | 52 · Reduced service | $33.88 | $67.61 | $85.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.49 Median $26.92 Typical High $33.88 | Professional | 53 · Discontinued | $13.49 | $26.92 | $33.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $50.12 Median $102.33 Typical High $128.82 | Professional | 54 · Surgery only | $50.12 | $102.33 | $128.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $20.42 Typical High $25.70 | Professional | 55 · Aftercare only | $10.23 | $20.42 | $25.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $13.49 Typical High $16.98 | Professional | 56 · Pre-op care only | $6.76 | $13.49 | $16.98 |
Where Florida sits
The same service costs 9.7 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 $4,351MT $447
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.