How much rates vary
Facilitymedian $1,023 · 10th to 90th $398 to $7,762Professionalmedian $214 · 10th to 90th $162 to $339
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 $3,890.45 Typical High $10,964.78 | Facility | None | $602.56 | $3,890.45 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $213.80 Median $223.87 Typical High $257.04 | Professional | None | $213.80 | $223.87 | $257.04 |
AvMed Setting Facility Modifier None Typical Low $213.80 Median $2,137.96 Typical High $11,748.98 | Facility | None | $213.80 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $162.18 Median $186.21 Typical High $245.47 | Professional | None | $162.18 | $186.21 | $245.47 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $1,096.48 Typical High $11,481.54 | Facility | None | $512.86 | $1,096.48 | $11,481.54 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $173.78 Typical High $346.74 | Professional | None | $165.96 | $173.78 | $346.74 |
Florida Blue Setting Facility Modifier None Typical Low $389.05 Median $776.25 Typical High $7,413.10 | Facility | None | $389.05 | $776.25 | $7,413.10 |
Florida Blue Setting Professional Modifier None Typical Low $120.23 Median $245.47 Typical High $281.84 | Professional | None | $120.23 | $245.47 | $281.84 |
Molina Setting Professional Modifier None Typical Low $154.88 Median $173.78 Typical High $426.58 | Professional | None | $154.88 | $173.78 | $426.58 |
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 $165.96 Median $218.78 Typical High $363.08 | Professional | None | $165.96 | $218.78 | $363.08 |
Wellpoint Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $162.18 | Professional | None | $162.18 | $162.18 | $162.18 |
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 $107.15 Median $112.20 Typical High $128.82 | Professional | 52 · Reduced service | $107.15 | $112.20 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $42.66 Median $44.67 Typical High $51.29 | Professional | 53 · Discontinued | $42.66 | $44.67 | $51.29 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $162.18 Median $169.82 Typical High $190.55 | Professional | 54 · Surgery only | $162.18 | $169.82 | $190.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $32.36 Median $33.88 Typical High $38.02 | Professional | 55 · Aftercare only | $32.36 | $33.88 | $38.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.38 Median $22.39 Typical High $25.70 | Professional | 56 · Pre-op care only | $21.38 | $22.39 | $25.70 |
Where Florida sits
The same service costs 5.9 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 $4,297MT $726
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.