How much rates vary
Facilitymedian $575 · 10th to 90th $229 to $5,754Professionalmedian $158 · 10th to 90th $56 to $309
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 $173.78 Median $3,019.95 Typical High $10,715.19 | Facility | None | $173.78 | $3,019.95 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $61.66 Median $158.49 Typical High $257.04 | Professional | None | $61.66 | $158.49 | $257.04 |
Ambetter Setting Professional Modifier None Typical Low $83.18 Median $85.11 Typical High $85.11 | Professional | None | $83.18 | $85.11 | $85.11 |
AvMed Setting Facility Modifier None Typical Low $251.19 Median $2,137.96 Typical High $11,748.98 | Facility | None | $251.19 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $74.13 Median $229.09 Typical High $316.23 | Professional | None | $74.13 | $229.09 | $316.23 |
Cigna Setting Facility Modifier None Typical Low $257.04 Median $457.09 Typical High $2,691.53 | Facility | None | $257.04 | $457.09 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $53.70 Median $190.55 Typical High $275.42 | Professional | None | $53.70 | $190.55 | $275.42 |
Florida Blue Setting Facility Modifier None Typical Low $199.53 Median $436.52 Typical High $5,370.32 | Facility | None | $199.53 | $436.52 | $5,370.32 |
Florida Blue Setting Professional Modifier None Typical Low $64.57 Median $141.25 Typical High $346.74 | Professional | None | $64.57 | $141.25 | $346.74 |
Molina Setting Professional Modifier None Typical Low $74.13 Median $251.19 Typical High $616.60 | Professional | None | $74.13 | $251.19 | $616.60 |
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 $54.95 Median $144.54 Typical High $269.15 | Professional | None | $54.95 | $144.54 | $269.15 |
Wellpoint Setting Professional Modifier None Typical Low $54.95 Median $114.82 Typical High $114.82 | Professional | None | $54.95 | $114.82 | $114.82 |
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 $30.90 Median $79.43 Typical High $102.33 | Professional | 52 · Reduced service | $30.90 | $79.43 | $102.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.30 Median $31.62 Typical High $40.74 | Professional | 53 · Discontinued | $12.30 | $31.62 | $40.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $46.77 Median $120.23 Typical High $154.88 | Professional | 54 · Surgery only | $46.77 | $120.23 | $154.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.33 Median $23.99 Typical High $30.90 | Professional | 55 · Aftercare only | $9.33 | $23.99 | $30.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.17 Median $15.85 Typical High $20.42 | Professional | 56 · Pre-op care only | $6.17 | $15.85 | $20.42 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $66.07 Median $66.07 Typical High $66.07 | Professional | 59 · Distinct service | $66.07 | $66.07 | $66.07 |
Where Florida sits
The same service costs 9.0 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 $4,579MT $507
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.