How much rates vary
Facilitymedian $1,072 · 10th to 90th $427 to $6,607Professionalmedian $229 · 10th to 90th $98 to $427
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 $398.11 Median $3,090.30 Typical High $10,964.78 | Facility | None | $398.11 | $3,090.30 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $117.49 Median $141.25 Typical High $346.74 | Professional | None | $117.49 | $141.25 | $346.74 |
AvMed Setting Facility Modifier None Typical Low $338.84 Median $1,288.25 Typical High $9,549.93 | Facility | None | $338.84 | $1,288.25 | $9,549.93 |
AvMed Setting Professional Modifier None Typical Low $123.03 Median $323.59 Typical High $426.58 | Professional | None | $123.03 | $323.59 | $426.58 |
Cigna Setting Facility Modifier None Typical Low $323.59 Median $1,047.13 Typical High $1,659.59 | Facility | None | $323.59 | $1,047.13 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $93.33 Median $251.19 Typical High $380.19 | Professional | None | $93.33 | $251.19 | $380.19 |
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 $69.18 Median $158.49 Typical High $467.74 | Professional | None | $69.18 | $158.49 | $467.74 |
Molina Setting Professional Modifier None Typical Low $120.23 Median $331.13 Typical High $812.83 | Professional | None | $120.23 | $331.13 | $812.83 |
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 $97.72 Median $162.18 Typical High $389.05 | Professional | None | $97.72 | $162.18 | $389.05 |
Wellpoint Setting Professional Modifier None Typical Low $91.20 Median $177.83 Typical High $177.83 | Professional | None | $91.20 | $177.83 | $177.83 |
6 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 $58.88 Median $67.61 Typical High $162.18 | Professional | 52 · Reduced service | $58.88 | $67.61 | $162.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $27.54 Typical High $64.57 | Professional | 53 · Discontinued | $23.44 | $27.54 | $64.57 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $89.13 Median $102.33 Typical High $239.88 | Professional | 54 · Surgery only | $89.13 | $102.33 | $239.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $20.42 Typical High $47.86 | Professional | 55 · Aftercare only | $17.78 | $20.42 | $47.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $13.80 Typical High $32.36 | Professional | 56 · Pre-op care only | $11.75 | $13.80 | $32.36 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $109.65 Median $109.65 Typical High $109.65 | Professional | 59 · Distinct service | $109.65 | $109.65 | $109.65 |
Where Florida sits
The same service costs 5.7 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 $4,090MT $722
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.