How much rates vary
Facilitymedian $1,660 · 10th to 90th $708 to $9,550Professionalmedian $380 · 10th to 90th $129 to $676
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 $2,884.03 Typical High $10,715.19 | Facility | None | $354.81 | $2,884.03 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $147.91 Median $380.19 Typical High $562.34 | Professional | None | $147.91 | $380.19 | $562.34 |
Ambetter Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $467.74 | Professional | None | $162.18 | $162.18 | $467.74 |
AvMed Setting Facility Modifier None Typical Low $380.19 Median $1,348.96 Typical High $9,549.93 | Facility | None | $380.19 | $1,348.96 | $9,549.93 |
AvMed Setting Professional Modifier None Typical Low $177.83 Median $489.78 Typical High $645.65 | Professional | None | $177.83 | $489.78 | $645.65 |
Cigna Setting Facility Modifier None Typical Low $323.59 Median $1,584.89 Typical High $2,691.53 | Facility | None | $323.59 | $1,584.89 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $128.82 Median $371.54 Typical High $562.34 | Professional | None | $128.82 | $371.54 | $562.34 |
Florida Blue Setting Facility Modifier None Typical Low $870.96 Median $1,819.70 Typical High $11,748.98 | Facility | None | $870.96 | $1,819.70 | $11,748.98 |
Florida Blue Setting Professional Modifier None Typical Low $218.78 Median $338.84 Typical High $691.83 | Professional | None | $218.78 | $338.84 | $691.83 |
Molina Setting Professional Modifier None Typical Low $57.54 Median $436.52 Typical High $1,023.29 | Professional | None | $57.54 | $436.52 | $1,023.29 |
United Setting Facility Modifier None Typical Low $794.33 Median $1,778.28 Typical High $7,585.78 | Facility | None | $794.33 | $1,778.28 | $7,585.78 |
United Setting Professional Modifier None Typical Low $131.83 Median $338.84 Typical High $575.44 | Professional | None | $131.83 | $338.84 | $575.44 |
Wellpoint Setting Professional Modifier None Typical Low $134.90 Median $467.74 Typical High $467.74 | Professional | None | $134.90 | $467.74 | $467.74 |
7 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 $74.13 Median $190.55 Typical High $239.88 | Professional | 52 · Reduced service | $74.13 | $190.55 | $239.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $29.51 Median $75.86 Typical High $95.50 | Professional | 53 · Discontinued | $29.51 | $75.86 | $95.50 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $112.20 Median $288.40 Typical High $363.08 | Professional | 54 · Surgery only | $112.20 | $288.40 | $363.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $57.54 Typical High $72.44 | Professional | 55 · Aftercare only | $22.39 | $57.54 | $72.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.79 Median $38.02 Typical High $47.86 | Professional | 56 · Pre-op care only | $14.79 | $38.02 | $47.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $104.71 Median $269.15 Typical High $338.84 | Professional | 78 · Unplanned return to OR | $104.71 | $269.15 | $338.84 |
Ambetter Setting Professional Modifier 51 · Multiple procedures Typical Low $102.33 Median $102.33 Typical High $154.88 | Professional | 51 · Multiple procedures | $102.33 | $102.33 | $154.88 |
Where Florida sits
The same service costs 4.4 times more in Colorado than in North Dakota. 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 $4,844ND $1,099
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.