How much rates vary
Facilitymedian $6,026 · 10th to 90th $1,862 to $18,621Professionalmedian $1,122 · 10th to 90th $120 to $2,188
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 $891.25 Median $6,456.54 Typical High $14,454.40 | Facility | None | $891.25 | $6,456.54 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $1,258.93 Median $1,513.56 Typical High $2,570.40 | Professional | None | $1,258.93 | $1,513.56 | $2,570.40 |
Ambetter Setting Professional Modifier None Typical Low $537.03 Median $1,071.52 Typical High $2,691.53 | Professional | None | $537.03 | $1,071.52 | $2,691.53 |
AvMed Setting Facility Modifier None Typical Low $933.25 Median $2,137.96 Typical High $10,964.78 | Facility | None | $933.25 | $2,137.96 | $10,964.78 |
AvMed Setting Professional Modifier None Typical Low $933.25 Median $1,230.27 Typical High $1,949.84 | Professional | None | $933.25 | $1,230.27 | $1,949.84 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $6,309.57 Typical High $14,125.38 | Facility | None | $549.54 | $6,309.57 | $14,125.38 |
Cigna Setting Professional Modifier None Typical Low $851.14 Median $1,258.93 Typical High $2,818.38 | Professional | None | $851.14 | $1,258.93 | $2,818.38 |
Florida Blue Setting Facility Modifier None Typical Low $2,884.03 Median $5,888.44 Typical High $19,952.62 | Facility | None | $2,884.03 | $5,888.44 | $19,952.62 |
Florida Blue Setting Professional Modifier None Typical Low $776.25 Median $870.96 Typical High $1,778.28 | Professional | None | $776.25 | $870.96 | $1,778.28 |
Molina Setting Professional Modifier None Typical Low $104.71 Median $1,000.00 Typical High $2,041.74 | Professional | None | $104.71 | $1,000.00 | $2,041.74 |
United Setting Facility Modifier None Typical Low $2,511.89 Median $10,000.00 Typical High $19,498.45 | Facility | None | $2,511.89 | $10,000.00 | $19,498.45 |
United Setting Professional Modifier None Typical Low $60.26 Median $1,659.59 Typical High $2,951.21 | Professional | None | $60.26 | $1,659.59 | $2,951.21 |
Wellpoint Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $1,122.02 | Professional | None | $851.14 | $851.14 | $1,122.02 |
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 $630.96 Median $645.65 Typical High $870.96 | Professional | 52 · Reduced service | $630.96 | $645.65 | $870.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $251.19 Median $257.04 Typical High $346.74 | Professional | 53 · Discontinued | $251.19 | $257.04 | $346.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $977.24 Typical High $1,288.25 | Professional | 54 · Surgery only | $933.25 | $977.24 | $1,288.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $190.55 Median $194.98 Typical High $257.04 | Professional | 55 · Aftercare only | $190.55 | $194.98 | $257.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $125.89 Median $128.82 Typical High $173.78 | Professional | 56 · Pre-op care only | $125.89 | $128.82 | $173.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $912.01 Typical High $1,202.26 | Professional | 78 · Unplanned return to OR | $870.96 | $912.01 | $1,202.26 |
Ambetter Setting Professional Modifier 80 · Assistant surgeon Typical Low $85.11 Median $85.11 Typical High $169.82 | Professional | 80 · Assistant surgeon | $85.11 | $85.11 | $169.82 |
Where Florida sits
The same service costs 4.8 times more in Colorado than in Kentucky. 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 $16,697KY $3,454
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.