How much rates vary
Facilitymedian $3,311 · 10th to 90th $1,413 to $14,125Professionalmedian $525 · 10th to 90th $85 to $977
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 $660.69 Median $5,495.41 Typical High $12,302.69 | Facility | None | $660.69 | $5,495.41 | $12,302.69 |
Aetna Setting Professional Modifier None Typical Low $537.03 Median $616.60 Typical High $707.95 | Professional | None | $537.03 | $616.60 | $707.95 |
AvMed Setting Facility Modifier None Typical Low $537.03 Median $2,884.03 Typical High $12,882.50 | Facility | None | $537.03 | $2,884.03 | $12,882.50 |
AvMed Setting Professional Modifier None Typical Low $512.86 Median $630.96 Typical High $724.44 | Professional | None | $512.86 | $630.96 | $724.44 |
Cigna Setting Facility Modifier None Typical Low $660.69 Median $3,311.31 Typical High $11,481.54 | Facility | None | $660.69 | $3,311.31 | $11,481.54 |
Cigna Setting Professional Modifier None Typical Low $467.74 Median $501.19 Typical High $891.25 | Professional | None | $467.74 | $501.19 | $891.25 |
Florida Blue Setting Facility Modifier None Typical Low $1,584.89 Median $3,162.28 Typical High $16,982.44 | Facility | None | $1,584.89 | $3,162.28 | $16,982.44 |
Florida Blue Setting Professional Modifier None Typical Low $309.03 Median $602.56 Typical High $741.31 | Professional | None | $309.03 | $602.56 | $741.31 |
Molina Setting Professional Modifier None Typical Low $54.95 Median $489.78 Typical High $1,122.02 | Professional | None | $54.95 | $489.78 | $1,122.02 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $3,548.13 Typical High $12,589.25 | Facility | None | $1,230.27 | $3,548.13 | $12,589.25 |
United Setting Professional Modifier None Typical Low $446.68 Median $575.44 Typical High $954.99 | Professional | None | $446.68 | $575.44 | $954.99 |
Wellpoint Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $467.74 | Professional | None | $467.74 | $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 $263.03 Median $309.03 Typical High $338.84 | Professional | 52 · Reduced service | $263.03 | $309.03 | $338.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $123.03 Typical High $138.04 | Professional | 53 · Discontinued | $107.15 | $123.03 | $138.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $398.11 Median $457.09 Typical High $512.86 | Professional | 54 · Surgery only | $398.11 | $457.09 | $512.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $91.20 Typical High $102.33 | Professional | 55 · Aftercare only | $79.43 | $91.20 | $102.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $61.66 Typical High $69.18 | Professional | 56 · Pre-op care only | $53.70 | $61.66 | $69.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $371.54 Median $426.58 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $371.54 | $426.58 | $478.63 |
Ambetter Setting Professional Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $851.14 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $851.14 | $851.14 | $851.14 |
Where Florida sits
The same service costs 5.4 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 $11,084MT $2,070
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.