How much rates vary
Facilitymedian $3,467 · 10th to 90th $1,413 to $13,183Professionalmedian $776 · 10th to 90th $115 to $1,479
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 $812.83 Median $6,456.54 Typical High $14,125.38 | Facility | None | $812.83 | $6,456.54 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $758.58 Median $794.33 Typical High $1,819.70 | Professional | None | $758.58 | $794.33 | $1,819.70 |
Ambetter Setting Professional Modifier None Typical Low $776.25 Median $812.83 Typical High $891.25 | Professional | None | $776.25 | $812.83 | $891.25 |
AvMed Setting Facility Modifier None Typical Low $794.33 Median $3,981.07 Typical High $9,772.37 | Facility | None | $794.33 | $3,981.07 | $9,772.37 |
AvMed Setting Professional Modifier None Typical Low $707.95 Median $891.25 Typical High $1,071.52 | Professional | None | $707.95 | $891.25 | $1,071.52 |
Cigna Setting Facility Modifier None Typical Low $1,288.25 Median $3,548.13 Typical High $6,760.83 | Facility | None | $1,288.25 | $3,548.13 | $6,760.83 |
Cigna Setting Professional Modifier None Typical Low $660.69 Median $912.01 Typical High $1,737.80 | Professional | None | $660.69 | $912.01 | $1,737.80 |
Florida Blue Setting Facility Modifier None Typical Low $1,584.89 Median $3,162.28 Typical High $16,982.44 | Facility | None | $1,584.89 | $3,162.28 | $16,982.44 |
Florida Blue Setting Professional Modifier None Typical Low $588.84 Median $630.96 Typical High $933.25 | Professional | None | $588.84 | $630.96 | $933.25 |
Molina Setting Professional Modifier None Typical Low $104.71 Median $691.83 Typical High $1,380.38 | Professional | None | $104.71 | $691.83 | $1,380.38 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $3,388.44 Typical High $12,589.25 | Facility | None | $1,230.27 | $3,388.44 | $12,589.25 |
United Setting Professional Modifier None Typical Low $60.26 Median $1,000.00 Typical High $1,862.09 | Professional | None | $60.26 | $1,000.00 | $1,862.09 |
Wellpoint Setting Professional Modifier None Typical Low $630.96 Median $630.96 Typical High $851.14 | Professional | None | $630.96 | $630.96 | $851.14 |
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 $380.19 Median $398.11 Typical High $489.78 | Professional | 52 · Reduced service | $380.19 | $398.11 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $158.49 Typical High $194.98 | Professional | 53 · Discontinued | $151.36 | $158.49 | $194.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $588.84 Typical High $724.44 | Professional | 54 · Surgery only | $575.44 | $588.84 | $724.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $117.49 Typical High $144.54 | Professional | 55 · Aftercare only | $114.82 | $117.49 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $79.43 Typical High $97.72 | Professional | 56 · Pre-op care only | $75.86 | $79.43 | $97.72 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $549.54 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $537.03 | $549.54 | $676.08 |
Where Florida sits
The same service costs 4.2 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 $11,551MT $2,762
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.