How much rates vary
Facilitymedian $4,266 · 10th to 90th $457 to $26,303Professionalmedian $2,042 · 10th to 90th $224 to $3,715
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 $776.25 Median $4,786.30 Typical High $12,022.64 | Facility | None | $776.25 | $4,786.30 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $2,041.74 Median $2,454.71 Typical High $2,818.38 | Professional | None | $2,041.74 | $2,454.71 | $2,818.38 |
AvMed Setting Facility Modifier None Typical Low $1,445.44 Median $2,511.89 Typical High $11,748.98 | Facility | None | $1,445.44 | $2,511.89 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $2,137.96 Median $2,454.71 Typical High $3,090.30 | Professional | None | $2,137.96 | $2,454.71 | $3,090.30 |
Cigna Setting Professional Modifier None Typical Low $4,168.69 Median $4,168.69 Typical High $5,248.07 | Professional | None | $4,168.69 | $4,168.69 | $5,248.07 |
Florida Blue Setting Facility Modifier None Typical Low $10,471.29 Median $22,387.21 Typical High $33,884.42 | Facility | None | $10,471.29 | $22,387.21 | $33,884.42 |
Florida Blue Setting Professional Modifier None Typical Low $1,202.26 Median $2,041.74 Typical High $3,090.30 | Professional | None | $1,202.26 | $2,041.74 | $3,090.30 |
Molina Setting Professional Modifier None Typical Low $208.93 Median $1,819.70 Typical High $4,365.16 | Professional | None | $208.93 | $1,819.70 | $4,365.16 |
United Setting Facility Modifier None Typical Low $371.54 Median $954.99 Typical High $7,585.78 | Facility | None | $371.54 | $954.99 | $7,585.78 |
United Setting Professional Modifier None Typical Low $1,778.28 Median $2,290.87 Typical High $3,801.89 | Professional | None | $1,778.28 | $2,290.87 | $3,801.89 |
Wellpoint Setting Professional Modifier None Typical Low $1,995.26 Median $1,995.26 Typical High $1,995.26 | Professional | None | $1,995.26 | $1,995.26 | $1,995.26 |
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 $1,023.29 Median $1,230.27 Typical High $1,380.38 | Professional | 52 · Reduced service | $1,023.29 | $1,230.27 | $1,380.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $407.38 Median $489.78 Typical High $562.34 | Professional | 53 · Discontinued | $407.38 | $489.78 | $562.34 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,548.82 Median $1,862.09 Typical High $2,089.30 | Professional | 54 · Surgery only | $1,548.82 | $1,862.09 | $2,089.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $309.03 Median $371.54 Typical High $416.87 | Professional | 55 · Aftercare only | $309.03 | $371.54 | $416.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $204.17 Median $245.47 Typical High $275.42 | Professional | 56 · Pre-op care only | $204.17 | $245.47 | $275.42 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,445.44 Median $1,737.80 Typical High $1,949.84 | Professional | 78 · Unplanned return to OR | $1,445.44 | $1,737.80 | $1,949.84 |
Where Florida sits
The same service costs 7.8 times more in Colorado than in Texas. 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 $22,169TX $2,853
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.