How much rates vary
Facilitymedian $2,042 · 10th to 90th $562 to $6,310Professionalmedian $200 · 10th to 90th $148 to $389
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 $758.58 Median $4,897.79 Typical High $12,882.50 | Facility | None | $758.58 | $4,897.79 | $12,882.50 |
Aetna Setting Professional Modifier None Typical Low $177.83 Median $190.55 Typical High $281.84 | Professional | None | $177.83 | $190.55 | $281.84 |
AvMed Setting Facility Modifier None Typical Low $186.21 Median $2,137.96 Typical High $11,748.98 | Facility | None | $186.21 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $154.88 Median $213.80 Typical High $338.84 | Professional | None | $154.88 | $213.80 | $338.84 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $1,000.00 Typical High $2,691.53 | Facility | None | $501.19 | $1,000.00 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $147.91 Median $208.93 Typical High $457.09 | Professional | None | $147.91 | $208.93 | $457.09 |
Florida Blue Setting Facility Modifier None Typical Low $1,230.27 Median $2,570.40 Typical High $6,309.57 | Facility | None | $1,230.27 | $2,570.40 | $6,309.57 |
Florida Blue Setting Professional Modifier None Typical Low $128.82 Median $144.54 Typical High $316.23 | Professional | None | $128.82 | $144.54 | $316.23 |
Molina Setting Professional Modifier None Typical Low $138.04 Median $199.53 Typical High $363.08 | Professional | None | $138.04 | $199.53 | $363.08 |
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 $60.26 Median $257.04 Typical High $467.74 | Professional | None | $60.26 | $257.04 | $467.74 |
Wellpoint Setting Professional Modifier None Typical Low $173.78 Median $173.78 Typical High $186.21 | Professional | None | $173.78 | $173.78 | $186.21 |
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 $89.13 Median $93.33 Typical High $141.25 | Professional | 52 · Reduced service | $89.13 | $93.33 | $141.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $38.02 Typical High $56.23 | Professional | 53 · Discontinued | $35.48 | $38.02 | $56.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $131.83 Median $141.25 Typical High $208.93 | Professional | 54 · Surgery only | $131.83 | $141.25 | $208.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $28.18 Typical High $42.66 | Professional | 55 · Aftercare only | $26.92 | $28.18 | $42.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $19.05 Typical High $28.18 | Professional | 56 · Pre-op care only | $17.78 | $19.05 | $28.18 |
Where Florida sits
The same service costs 7.6 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 $4,681MT $618
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.