How much rates vary
Facilitymedian $1,995 · 10th to 90th $794 to $11,749Professionalmedian $589 · 10th to 90th $151 to $1,202
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 $478.63 Median $3,090.30 Typical High $10,471.29 | Facility | None | $478.63 | $3,090.30 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $147.91 Median $562.34 Typical High $912.01 | Professional | None | $147.91 | $562.34 | $912.01 |
Ambetter Setting Professional Modifier None Typical Low $87.10 Median $245.47 Typical High $741.31 | Professional | None | $87.10 | $245.47 | $741.31 |
AvMed Setting Facility Modifier None Typical Low $501.19 Median $1,698.24 Typical High $9,772.37 | Facility | None | $501.19 | $1,698.24 | $9,772.37 |
AvMed Setting Professional Modifier None Typical Low $181.97 Median $630.96 Typical High $831.76 | Professional | None | $181.97 | $630.96 | $831.76 |
Cigna Setting Facility Modifier None Typical Low $436.52 Median $1,949.84 Typical High $3,019.95 | Facility | None | $436.52 | $1,949.84 | $3,019.95 |
Cigna Setting Professional Modifier None Typical Low $151.36 Median $537.03 Typical High $1,230.27 | Professional | None | $151.36 | $537.03 | $1,230.27 |
Florida Blue Setting Facility Modifier None Typical Low $1,047.13 Median $2,089.30 Typical High $16,982.44 | Facility | None | $1,047.13 | $2,089.30 | $16,982.44 |
Florida Blue Setting Professional Modifier None Typical Low $331.13 Median $524.81 Typical High $776.25 | Professional | None | $331.13 | $524.81 | $776.25 |
Molina Setting Professional Modifier None Typical Low $537.03 Median $776.25 Typical High $1,513.56 | Professional | None | $537.03 | $776.25 | $1,513.56 |
United Setting Facility Modifier None Typical Low $794.33 Median $1,698.24 Typical High $7,585.78 | Facility | None | $794.33 | $1,698.24 | $7,585.78 |
United Setting Professional Modifier None Typical Low $151.36 Median $512.86 Typical High $1,348.96 | Professional | None | $151.36 | $512.86 | $1,348.96 |
Wellpoint Setting Professional Modifier None Typical Low $138.04 Median $588.84 Typical High $588.84 | Professional | None | $138.04 | $588.84 | $588.84 |
5 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 $281.84 Typical High $380.19 | Professional | 52 · Reduced service | $74.13 | $281.84 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $112.20 Typical High $151.36 | Professional | 53 · Discontinued | $30.20 | $112.20 | $151.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $112.20 Median $416.87 Typical High $575.44 | Professional | 54 · Surgery only | $112.20 | $416.87 | $575.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $83.18 Typical High $114.82 | Professional | 55 · Aftercare only | $22.39 | $83.18 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.79 Median $56.23 Typical High $75.86 | Professional | 56 · Pre-op care only | $14.79 | $56.23 | $75.86 |
Where Florida sits
The same service costs 3.8 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 $5,124MT $1,344
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.