How much rates vary
Facilitymedian $1,023 · 10th to 90th $417 to $5,495Professionalmedian $155 · 10th to 90th $110 to $263
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 $154.88 Median $162.18 Typical High $204.17 | Professional | None | $154.88 | $162.18 | $204.17 |
Ambetter Setting Professional Modifier None Typical Low $186.21 Median $186.21 Typical High $186.21 | Professional | None | $186.21 | $186.21 | $186.21 |
AvMed Setting Facility Modifier None Typical Low $331.13 Median $1,258.93 Typical High $9,549.93 | Facility | None | $331.13 | $1,258.93 | $9,549.93 |
AvMed Setting Professional Modifier None Typical Low $125.89 Median $154.88 Typical High $245.47 | Professional | None | $125.89 | $154.88 | $245.47 |
Cigna Setting Facility Modifier None Typical Low $331.13 Median $776.25 Typical High $1,659.59 | Facility | None | $331.13 | $776.25 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $120.23 Median $125.89 Typical High $269.15 | Professional | None | $120.23 | $125.89 | $269.15 |
Florida Blue Setting Facility Modifier None Typical Low $489.78 Median $1,071.52 Typical High $5,370.32 | Facility | None | $489.78 | $1,071.52 | $5,370.32 |
Florida Blue Setting Professional Modifier None Typical Low $109.65 Median $208.93 Typical High $257.04 | Professional | None | $109.65 | $208.93 | $257.04 |
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 $120.23 Median $173.78 Typical High $281.84 | Professional | None | $120.23 | $173.78 | $281.84 |
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 $77.62 Median $81.28 Typical High $102.33 | Professional | 52 · Reduced service | $77.62 | $81.28 | $102.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $32.36 Typical High $40.74 | Professional | 53 · Discontinued | $30.90 | $32.36 | $40.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $114.82 Median $120.23 Typical High $151.36 | Professional | 54 · Surgery only | $114.82 | $120.23 | $151.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $24.55 Typical High $30.90 | Professional | 55 · Aftercare only | $22.91 | $24.55 | $30.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $16.22 Typical High $20.42 | Professional | 56 · Pre-op care only | $15.49 | $16.22 | $20.42 |
Where Florida sits
The same service costs 7.7 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 $4,047MT $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.