How much rates vary
Facilitymedian $1,445 · 10th to 90th $537 to $6,607Professionalmedian $603 · 10th to 90th $141 to $955
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 $549.54 Median $3,090.30 Typical High $10,964.78 | Facility | None | $549.54 | $3,090.30 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $186.21 Median $645.65 Typical High $912.01 | Professional | None | $186.21 | $645.65 | $912.01 |
Ambetter Setting Professional Modifier None Typical Low $114.82 Median $158.49 Typical High $158.49 | Professional | None | $114.82 | $158.49 | $158.49 |
AvMed Setting Facility Modifier None Typical Low $630.96 Median $2,137.96 Typical High $11,748.98 | Facility | None | $630.96 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $173.78 Median $645.65 Typical High $891.25 | Professional | None | $173.78 | $645.65 | $891.25 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $912.01 Typical High $6,760.83 | Facility | None | $501.19 | $912.01 | $6,760.83 |
Cigna Setting Professional Modifier None Typical Low $138.04 Median $489.78 Typical High $912.01 | Professional | None | $138.04 | $489.78 | $912.01 |
Florida Blue Setting Facility Modifier None Typical Low $724.44 Median $1,621.81 Typical High $6,309.57 | Facility | None | $724.44 | $1,621.81 | $6,309.57 |
Florida Blue Setting Professional Modifier None Typical Low $407.38 Median $870.96 Typical High $977.24 | Professional | None | $407.38 | $870.96 | $977.24 |
Molina Setting Professional Modifier None Typical Low $173.78 Median $691.83 Typical High $1,698.24 | Professional | None | $173.78 | $691.83 | $1,698.24 |
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 $154.88 Median $549.54 Typical High $1,000.00 | Professional | None | $154.88 | $549.54 | $1,000.00 |
Wellpoint Setting Professional Modifier None Typical Low $131.83 Median $645.65 Typical High $645.65 | Professional | None | $131.83 | $645.65 | $645.65 |
8 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 $89.13 Median $316.23 Typical High $371.54 | Professional | 52 · Reduced service | $89.13 | $316.23 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $128.82 Typical High $147.91 | Professional | 53 · Discontinued | $35.48 | $128.82 | $147.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $134.90 Median $478.63 Typical High $549.54 | Professional | 54 · Surgery only | $134.90 | $478.63 | $549.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $95.50 Typical High $109.65 | Professional | 55 · Aftercare only | $26.30 | $95.50 | $109.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $64.57 Typical High $74.13 | Professional | 56 · Pre-op care only | $17.78 | $64.57 | $74.13 |
Ambetter Setting Professional Modifier 76 · Repeat, same provider Typical Low $81.28 Median $81.28 Typical High $81.28 | Professional | 76 · Repeat, same provider | $81.28 | $81.28 | $81.28 |
Ambetter Setting Professional Modifier GC · Resident with teaching physician Typical Low $173.78 Median $173.78 Typical High $173.78 | Professional | GC · Resident with teaching physician | $173.78 | $173.78 | $173.78 |
Ambetter Setting Professional Modifier XE · Separate encounter Typical Low $158.49 Median $158.49 Typical High $158.49 | Professional | XE · Separate encounter | $158.49 | $158.49 | $158.49 |
Where Florida sits
The same service costs 5.2 times more in Colorado than in Maryland. 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 $5,090MD $982
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.