How much rates vary
Facilitymedian $1,148 · 10th to 90th $457 to $6,607Professionalmedian $309 · 10th to 90th $145 to $589
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 $354.81 Median $3,090.30 Typical High $10,715.19 | Facility | None | $354.81 | $3,090.30 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $181.97 Median $239.88 Typical High $562.34 | Professional | None | $181.97 | $239.88 | $562.34 |
Ambetter Setting Professional Modifier None Typical Low $165.96 Median $245.47 Typical High $524.81 | Professional | None | $165.96 | $245.47 | $524.81 |
AvMed Setting Facility Modifier None Typical Low $446.68 Median $1,479.11 Typical High $9,549.93 | Facility | None | $446.68 | $1,479.11 | $9,549.93 |
AvMed Setting Professional Modifier None Typical Low $177.83 Median $426.58 Typical High $562.34 | Professional | None | $177.83 | $426.58 | $562.34 |
Cigna Setting Facility Modifier None Typical Low $436.52 Median $1,047.13 Typical High $2,187.76 | Facility | None | $436.52 | $1,047.13 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $138.04 Median $338.84 Typical High $512.86 | Professional | None | $138.04 | $338.84 | $512.86 |
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 $107.15 Median $245.47 Typical High $616.60 | Professional | None | $107.15 | $245.47 | $616.60 |
Molina Setting Professional Modifier None Typical Low $177.83 Median $446.68 Typical High $1,096.48 | Professional | None | $177.83 | $446.68 | $1,096.48 |
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 $147.91 Median $245.47 Typical High $524.81 | Professional | None | $147.91 | $245.47 | $524.81 |
Wellpoint Setting Professional Modifier None Typical Low $134.90 Median $302.00 Typical High $302.00 | Professional | None | $134.90 | $302.00 | $302.00 |
10 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 $102.33 Typical High $223.87 | Professional | 52 · Reduced service | $89.13 | $102.33 | $223.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $41.69 Typical High $89.13 | Professional | 53 · Discontinued | $35.48 | $41.69 | $89.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $134.90 Median $154.88 Typical High $331.13 | Professional | 54 · Surgery only | $134.90 | $154.88 | $331.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $30.90 Typical High $67.61 | Professional | 55 · Aftercare only | $26.92 | $30.90 | $67.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $20.89 Typical High $44.67 | Professional | 56 · Pre-op care only | $17.78 | $20.89 | $44.67 |
Ambetter Setting Professional Modifier 33 · Preventive service Typical Low $177.83 Median $177.83 Typical High $177.83 | Professional | 33 · Preventive service | $177.83 | $177.83 | $177.83 |
Ambetter Setting Professional Modifier 51 · Multiple procedures Typical Low $81.28 Median $81.28 Typical High $162.18 | Professional | 51 · Multiple procedures | $81.28 | $81.28 | $162.18 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $162.18 Median $162.18 Typical High $489.78 | Professional | 59 · Distinct service | $162.18 | $162.18 | $489.78 |
Ambetter Setting Professional Modifier PT · Screening turned treatment Typical Low $208.93 Median $208.93 Typical High $208.93 | Professional | PT · Screening turned treatment | $208.93 | $208.93 | $208.93 |
Ambetter Setting Professional Modifier XS · Separate structure Typical Low $245.47 Median $245.47 Typical High $245.47 | Professional | XS · Separate structure | $245.47 | $245.47 | $245.47 |
Where Florida sits
The same service costs 4.1 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 $4,142MT $1,002
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.