How much rates vary
Facilitymedian $4,786 · 10th to 90th $1,862 to $13,804Professionalmedian $1,047 · 10th to 90th $155 to $1,698
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 $851.14 Median $5,495.41 Typical High $13,182.57 | Facility | None | $851.14 | $5,495.41 | $13,182.57 |
Aetna Setting Professional Modifier None Typical Low $1,096.48 Median $1,202.26 Typical High $1,621.81 | Professional | None | $1,096.48 | $1,202.26 | $1,621.81 |
Ambetter Setting Professional Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $1,202.26 | Professional | None | $1,202.26 | $1,202.26 | $1,202.26 |
AvMed Setting Facility Modifier None Typical Low $1,096.48 Median $2,137.96 Typical High $9,772.37 | Facility | None | $1,096.48 | $2,137.96 | $9,772.37 |
AvMed Setting Professional Modifier None Typical Low $1,023.29 Median $1,380.38 Typical High $1,584.89 | Professional | None | $1,023.29 | $1,380.38 | $1,584.89 |
Cigna Setting Facility Modifier None Typical Low $1,202.26 Median $4,265.80 Typical High $7,585.78 | Facility | None | $1,202.26 | $4,265.80 | $7,585.78 |
Cigna Setting Professional Modifier None Typical Low $954.99 Median $1,023.29 Typical High $2,089.30 | Professional | None | $954.99 | $1,023.29 | $2,089.30 |
Florida Blue Setting Facility Modifier None Typical Low $2,630.27 Median $5,495.41 Typical High $16,982.44 | Facility | None | $2,630.27 | $5,495.41 | $16,982.44 |
Florida Blue Setting Professional Modifier None Typical Low $562.34 Median $1,230.27 Typical High $1,445.44 | Professional | None | $562.34 | $1,230.27 | $1,445.44 |
Molina Setting Professional Modifier None Typical Low $138.04 Median $912.01 Typical High $1,548.82 | Professional | None | $138.04 | $912.01 | $1,548.82 |
United Setting Facility Modifier None Typical Low $1,659.59 Median $5,248.07 Typical High $15,135.61 | Facility | None | $1,659.59 | $5,248.07 | $15,135.61 |
United Setting Professional Modifier None Typical Low $891.25 Median $1,148.15 Typical High $2,238.72 | Professional | None | $891.25 | $1,148.15 | $2,238.72 |
Wellpoint Setting Professional Modifier None Typical Low $954.99 Median $954.99 Typical High $1,288.25 | Professional | None | $954.99 | $954.99 | $1,288.25 |
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 $549.54 Median $602.56 Typical High $724.44 | Professional | 52 · Reduced service | $549.54 | $602.56 | $724.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $218.78 Median $239.88 Typical High $295.12 | Professional | 53 · Discontinued | $218.78 | $239.88 | $295.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $912.01 Typical High $1,096.48 | Professional | 54 · Surgery only | $812.83 | $912.01 | $1,096.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $181.97 Typical High $218.78 | Professional | 55 · Aftercare only | $162.18 | $181.97 | $218.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $120.23 Typical High $147.91 | Professional | 56 · Pre-op care only | $109.65 | $120.23 | $147.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $851.14 Typical High $1,023.29 | Professional | 78 · Unplanned return to OR | $758.58 | $851.14 | $1,023.29 |
Where Florida sits
The same service costs 4.7 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 $15,002KY $3,224
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.