How much rates vary
Facilitymedian $1,820 · 10th to 90th $759 to $11,749Professionalmedian $158 · 10th to 90th $105 to $302
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 $3,801.89 Typical High $10,964.78 | Facility | None | $478.63 | $3,801.89 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $154.88 Median $158.49 Typical High $288.40 | Professional | None | $154.88 | $158.49 | $288.40 |
Ambetter Setting Professional Modifier None Typical Low $154.88 Median $154.88 Typical High $213.80 | Professional | None | $154.88 | $154.88 | $213.80 |
AvMed Setting Facility Modifier None Typical Low $446.68 Median $1,698.24 Typical High $9,549.93 | Facility | None | $446.68 | $1,698.24 | $9,549.93 |
AvMed Setting Professional Modifier None Typical Low $141.25 Median $181.97 Typical High $208.93 | Professional | None | $141.25 | $181.97 | $208.93 |
Cigna Setting Facility Modifier None Typical Low $436.52 Median $1,949.84 Typical High $3,090.30 | Facility | None | $436.52 | $1,949.84 | $3,090.30 |
Cigna Setting Professional Modifier None Typical Low $131.83 Median $186.21 Typical High $354.81 | Professional | None | $131.83 | $186.21 | $354.81 |
Florida Blue Setting Facility Modifier None Typical Low $891.25 Median $1,737.80 Typical High $16,982.44 | Facility | None | $891.25 | $1,737.80 | $16,982.44 |
Florida Blue Setting Professional Modifier None Typical Low $117.49 Median $125.89 Typical High $251.19 | Professional | None | $117.49 | $125.89 | $251.19 |
Molina Setting Professional Modifier None Typical Low $89.13 Median $144.54 Typical High $288.40 | Professional | None | $89.13 | $144.54 | $288.40 |
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 $204.17 Typical High $380.19 | Professional | None | $60.26 | $204.17 | $380.19 |
Wellpoint Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $169.82 | Professional | None | $125.89 | $125.89 | $169.82 |
6 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 $77.62 Median $79.43 Typical High $97.72 | Professional | 52 · Reduced service | $77.62 | $79.43 | $97.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $31.62 Typical High $38.90 | Professional | 53 · Discontinued | $30.90 | $31.62 | $38.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $114.82 Median $117.49 Typical High $144.54 | Professional | 54 · Surgery only | $114.82 | $117.49 | $144.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $23.44 Typical High $28.84 | Professional | 55 · Aftercare only | $22.91 | $23.44 | $28.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $15.85 Typical High $19.50 | Professional | 56 · Pre-op care only | $15.49 | $15.85 | $19.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $107.15 Median $109.65 Typical High $134.90 | Professional | 78 · Unplanned return to OR | $107.15 | $109.65 | $134.90 |
Where Florida sits
The same service costs 8.1 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 $4,634MT $570
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.