How much rates vary
Facilitymedian $2,818 · 10th to 90th $1,047 to $12,589Professionalmedian $617 · 10th to 90th $79 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 $758.58 Median $6,025.60 Typical High $12,882.50 | Facility | None | $758.58 | $6,025.60 | $12,882.50 |
Aetna Setting Professional Modifier None Typical Low $616.60 Median $645.65 Typical High $870.96 | Professional | None | $616.60 | $645.65 | $870.96 |
AvMed Setting Facility Modifier None Typical Low $660.69 Median $2,398.83 Typical High $9,772.37 | Facility | None | $660.69 | $2,398.83 | $9,772.37 |
AvMed Setting Professional Modifier None Typical Low $602.56 Median $758.58 Typical High $851.14 | Professional | None | $602.56 | $758.58 | $851.14 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $3,467.37 Typical High $5,754.40 | Facility | None | $707.95 | $3,467.37 | $5,754.40 |
Cigna Setting Professional Modifier None Typical Low $575.44 Median $776.25 Typical High $1,479.11 | Professional | None | $575.44 | $776.25 | $1,479.11 |
Florida Blue Setting Facility Modifier None Typical Low $1,318.26 Median $2,630.27 Typical High $16,982.44 | Facility | None | $1,318.26 | $2,630.27 | $16,982.44 |
Florida Blue Setting Professional Modifier None Typical Low $512.86 Median $549.54 Typical High $776.25 | Professional | None | $512.86 | $549.54 | $776.25 |
Molina Setting Professional Modifier None Typical Low $72.44 Median $549.54 Typical High $1,148.15 | Professional | None | $72.44 | $549.54 | $1,148.15 |
United Setting Facility Modifier None Typical Low $954.99 Median $2,344.23 Typical High $10,000.00 | Facility | None | $954.99 | $2,344.23 | $10,000.00 |
United Setting Professional Modifier None Typical Low $60.26 Median $851.14 Typical High $1,621.81 | Professional | None | $60.26 | $851.14 | $1,621.81 |
Wellpoint Setting Professional Modifier None Typical Low $549.54 Median $549.54 Typical High $724.44 | Professional | None | $549.54 | $549.54 | $724.44 |
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 $309.03 Median $316.23 Typical High $426.58 | Professional | 52 · Reduced service | $309.03 | $316.23 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $128.82 Typical High $169.82 | Professional | 53 · Discontinued | $123.03 | $128.82 | $169.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $478.63 Typical High $630.96 | Professional | 54 · Surgery only | $467.74 | $478.63 | $630.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $95.50 Typical High $128.82 | Professional | 55 · Aftercare only | $93.33 | $95.50 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $64.57 Typical High $85.11 | Professional | 56 · Pre-op care only | $61.66 | $64.57 | $85.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $446.68 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $436.52 | $446.68 | $588.84 |
Where Florida sits
The same service costs 5.3 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 $12,656MT $2,405
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.