How much rates vary
Facilitymedian $1,122 · 10th to 90th $407 to $7,413Professionalmedian $316 · 10th to 90th $135 to $525
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 $354.81 Median $3,019.95 Typical High $10,964.78 | Facility | None | $354.81 | $3,019.95 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $194.98 Median $338.84 Typical High $512.86 | Professional | None | $194.98 | $338.84 | $512.86 |
Ambetter Setting Professional Modifier None Typical Low $81.28 Median $416.87 Typical High $457.09 | Professional | None | $81.28 | $416.87 | $457.09 |
AvMed Setting Facility Modifier None Typical Low $446.68 Median $1,819.70 Typical High $9,772.37 | Facility | None | $446.68 | $1,819.70 | $9,772.37 |
AvMed Setting Professional Modifier None Typical Low $181.97 Median $380.19 Typical High $489.78 | Professional | None | $181.97 | $380.19 | $489.78 |
Cigna Setting Facility Modifier None Typical Low $416.87 Median $1,122.02 Typical High $1,819.70 | Facility | None | $416.87 | $1,122.02 | $1,819.70 |
Cigna Setting Professional Modifier None Typical Low $134.90 Median $302.00 Typical High $512.86 | Professional | None | $134.90 | $302.00 | $512.86 |
Florida Blue Setting Facility Modifier None Typical Low $389.05 Median $776.25 Typical High $7,413.10 | Facility | None | $389.05 | $776.25 | $7,413.10 |
Florida Blue Setting Professional Modifier None Typical Low $186.21 Median $407.38 Typical High $489.78 | Professional | None | $186.21 | $407.38 | $489.78 |
Molina Setting Professional Modifier None Typical Low $30.90 Median $338.84 Typical High $562.34 | Professional | None | $30.90 | $338.84 | $562.34 |
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 $162.18 Median $295.12 Typical High $602.56 | Professional | None | $162.18 | $295.12 | $602.56 |
Wellpoint Setting Professional Modifier None Typical Low $134.90 Median $354.81 Typical High $354.81 | Professional | None | $134.90 | $354.81 | $354.81 |
8 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 $97.72 Median $165.96 Typical High $208.93 | Professional | 52 · Reduced service | $97.72 | $165.96 | $208.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $67.61 Typical High $83.18 | Professional | 53 · Discontinued | $38.90 | $67.61 | $83.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $144.54 Median $251.19 Typical High $316.23 | Professional | 54 · Surgery only | $144.54 | $251.19 | $316.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $50.12 Typical High $63.10 | Professional | 55 · Aftercare only | $28.84 | $50.12 | $63.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $33.88 Typical High $41.69 | Professional | 56 · Pre-op care only | $19.50 | $33.88 | $41.69 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $134.90 Median $234.42 Typical High $295.12 | Professional | 78 · Unplanned return to OR | $134.90 | $234.42 | $295.12 |
Ambetter Setting Professional Modifier 50 · Both sides Typical Low $245.47 Median $630.96 Typical High $660.69 | Professional | 50 · Both sides | $245.47 | $630.96 | $660.69 |
Ambetter Setting Professional Modifier 53 · Discontinued Typical Low $416.87 Median $416.87 Typical High $416.87 | Professional | 53 · Discontinued | $416.87 | $416.87 | $416.87 |
Where Florida sits
The same service costs 4.6 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 $4,728MT $1,029
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.