How much rates vary
Facilitymedian $1,318 · 10th to 90th $501 to $6,607Professionalmedian $158 · 10th to 90th $112 to $257
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 $165.96 Median $169.82 Typical High $199.53 | Professional | None | $165.96 | $169.82 | $199.53 |
AvMed Setting Facility Modifier None Typical Low $446.68 Median $1,584.89 Typical High $9,549.93 | Facility | None | $446.68 | $1,584.89 | $9,549.93 |
AvMed Setting Professional Modifier None Typical Low $131.83 Median $165.96 Typical High $208.93 | Professional | None | $131.83 | $165.96 | $208.93 |
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 $128.82 Median $134.90 Typical High $275.42 | Professional | None | $128.82 | $134.90 | $275.42 |
Florida Blue Setting Facility Modifier None Typical Low $616.60 Median $1,348.96 Typical High $7,413.10 | Facility | None | $616.60 | $1,348.96 | $7,413.10 |
Florida Blue Setting Professional Modifier None Typical Low $95.50 Median $190.55 Typical High $229.09 | Professional | None | $95.50 | $190.55 | $229.09 |
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 $128.82 Median $165.96 Typical High $275.42 | Professional | None | $128.82 | $165.96 | $275.42 |
Wellpoint Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | None | $125.89 | $125.89 | $125.89 |
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 $83.18 Median $85.11 Typical High $97.72 | Professional | 52 · Reduced service | $83.18 | $85.11 | $97.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.11 Median $33.88 Typical High $38.90 | Professional | 53 · Discontinued | $33.11 | $33.88 | $38.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $123.03 Median $128.82 Typical High $147.91 | Professional | 54 · Surgery only | $123.03 | $128.82 | $147.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $25.70 Typical High $29.51 | Professional | 55 · Aftercare only | $24.55 | $25.70 | $29.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $16.98 Typical High $19.50 | Professional | 56 · Pre-op care only | $16.60 | $16.98 | $19.50 |
Where Florida sits
The same service costs 7.3 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 $4,136MT $564
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.