How much rates vary
Facilitymedian $1,122 · 10th to 90th $457 to $7,079Professionalmedian $141 · 10th to 90th $107 to $234
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 $3,235.94 Typical High $10,964.78 | Facility | None | $602.56 | $3,235.94 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $134.90 Median $158.49 Typical High $186.21 | Professional | None | $134.90 | $158.49 | $186.21 |
AvMed Setting Facility Modifier None Typical Low $151.36 Median $2,137.96 Typical High $11,748.98 | Facility | None | $151.36 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $117.49 Median $134.90 Typical High $177.83 | Professional | None | $117.49 | $134.90 | $177.83 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $1,047.13 Typical High $3,801.89 | Facility | None | $512.86 | $1,047.13 | $3,801.89 |
Cigna Setting Professional Modifier None Typical Low $123.03 Median $128.82 Typical High $239.88 | Professional | None | $123.03 | $128.82 | $239.88 |
Florida Blue Setting Facility Modifier None Typical Low $512.86 Median $1,071.52 Typical High $7,413.10 | Facility | None | $512.86 | $1,071.52 | $7,413.10 |
Florida Blue Setting Professional Modifier None Typical Low $72.44 Median $154.88 Typical High $177.83 | Professional | None | $72.44 | $154.88 | $177.83 |
Molina Setting Professional Modifier None Typical Low $104.71 Median $117.49 Typical High $288.40 | Professional | None | $104.71 | $117.49 | $288.40 |
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 $117.49 Median $151.36 Typical High $251.19 | Professional | None | $117.49 | $151.36 | $251.19 |
Wellpoint Setting Professional Modifier None Typical Low $117.49 Median $117.49 Typical High $117.49 | Professional | None | $117.49 | $117.49 | $117.49 |
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 $67.61 Median $79.43 Typical High $89.13 | Professional | 52 · Reduced service | $67.61 | $79.43 | $89.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.92 Median $32.36 Typical High $35.48 | Professional | 53 · Discontinued | $26.92 | $32.36 | $35.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $100.00 Median $120.23 Typical High $134.90 | Professional | 54 · Surgery only | $100.00 | $120.23 | $134.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $23.99 Typical High $26.92 | Professional | 55 · Aftercare only | $19.95 | $23.99 | $26.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.49 Median $15.85 Typical High $17.78 | Professional | 56 · Pre-op care only | $13.49 | $15.85 | $17.78 |
Where Florida sits
The same service costs 7.8 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 $4,120MT $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.