How much rates vary
Facilitymedian $1,820 · 10th to 90th $776 to $11,749Professionalmedian $191 · 10th to 90th $145 to $363
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 $407.38 Median $3,311.31 Typical High $11,481.54 | Facility | None | $407.38 | $3,311.31 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $181.97 Median $181.97 Typical High $257.04 | Professional | None | $181.97 | $181.97 | $257.04 |
AvMed Setting Facility Modifier None Typical Low $331.13 Median $1,513.56 Typical High $9,549.93 | Facility | None | $331.13 | $1,513.56 | $9,549.93 |
AvMed Setting Professional Modifier None Typical Low $165.96 Median $213.80 Typical High $239.88 | Professional | None | $165.96 | $213.80 | $239.88 |
Cigna Setting Facility Modifier None Typical Low $323.59 Median $1,659.59 Typical High $3,019.95 | Facility | None | $323.59 | $1,659.59 | $3,019.95 |
Cigna Setting Professional Modifier None Typical Low $147.91 Median $213.80 Typical High $398.11 | Professional | None | $147.91 | $213.80 | $398.11 |
Florida Blue Setting Facility Modifier None Typical Low $977.24 Median $1,949.84 Typical High $16,982.44 | Facility | None | $977.24 | $1,949.84 | $16,982.44 |
Florida Blue Setting Professional Modifier None Typical Low $138.04 Median $147.91 Typical High $239.88 | Professional | None | $138.04 | $147.91 | $239.88 |
Molina Setting Professional Modifier None Typical Low $131.83 Median $181.97 Typical High $354.81 | Professional | None | $131.83 | $181.97 | $354.81 |
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 $60.26 Median $229.09 Typical High $436.52 | Professional | None | $60.26 | $229.09 | $436.52 |
Wellpoint Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $199.53 | Professional | None | $151.36 | $151.36 | $199.53 |
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 $91.20 Median $91.20 Typical High $123.03 | Professional | 52 · Reduced service | $91.20 | $91.20 | $123.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $37.15 Typical High $48.98 | Professional | 53 · Discontinued | $36.31 | $37.15 | $48.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $138.04 Typical High $186.21 | Professional | 54 · Surgery only | $138.04 | $138.04 | $186.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $27.54 Typical High $37.15 | Professional | 55 · Aftercare only | $27.54 | $27.54 | $37.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $18.20 Typical High $24.55 | Professional | 56 · Pre-op care only | $18.20 | $18.20 | $24.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $128.82 Median $128.82 Typical High $173.78 | Professional | 78 · Unplanned return to OR | $128.82 | $128.82 | $173.78 |
Ambetter Setting Professional Modifier 50 · Both sides Typical Low $512.86 Median $512.86 Typical High $512.86 | Professional | 50 · Both sides | $512.86 | $512.86 | $512.86 |
Where Florida sits
The same service costs 9.6 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 $6,197MT $647
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.