How much rates vary
Facilitymedian $1,585 · 10th to 90th $661 to $7,413Professionalmedian $269 · 10th to 90th $98 to $437
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 $549.54 Median $4,073.80 Typical High $11,481.54 | Facility | None | $549.54 | $4,073.80 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $269.15 Median $288.40 Typical High $457.09 | Professional | None | $269.15 | $288.40 | $457.09 |
Ambetter Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $616.60 | Professional | None | $309.03 | $309.03 | $616.60 |
AvMed Setting Facility Modifier None Typical Low $446.68 Median $1,584.89 Typical High $9,549.93 | Facility | None | $446.68 | $1,584.89 | $9,549.93 |
AvMed Setting Professional Modifier None Typical Low $239.88 Median $316.23 Typical High $346.74 | Professional | None | $239.88 | $316.23 | $346.74 |
Cigna Setting Facility Modifier None Typical Low $436.52 Median $1,288.25 Typical High $2,187.76 | Facility | None | $436.52 | $1,288.25 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $251.19 Median $263.03 Typical High $549.54 | Professional | None | $251.19 | $263.03 | $549.54 |
Florida Blue Setting Facility Modifier None Typical Low $741.31 Median $1,621.81 Typical High $7,413.10 | Facility | None | $741.31 | $1,621.81 | $7,413.10 |
Florida Blue Setting Professional Modifier None Typical Low $158.49 Median $251.19 Typical High $371.54 | Professional | None | $158.49 | $251.19 | $371.54 |
Molina Setting Professional Modifier None Typical Low $60.26 Median $223.87 Typical High $398.11 | Professional | None | $60.26 | $223.87 | $398.11 |
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 $213.80 Median $302.00 Typical High $549.54 | Professional | None | $213.80 | $302.00 | $549.54 |
Wellpoint Setting Professional Modifier None Typical Low $251.19 Median $338.84 Typical High $338.84 | Professional | None | $251.19 | $338.84 | $338.84 |
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 $134.90 Median $141.25 Typical High $199.53 | Professional | 52 · Reduced service | $134.90 | $141.25 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $57.54 Typical High $79.43 | Professional | 53 · Discontinued | $54.95 | $57.54 | $79.43 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $204.17 Median $213.80 Typical High $295.12 | Professional | 54 · Surgery only | $204.17 | $213.80 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $42.66 Typical High $58.88 | Professional | 55 · Aftercare only | $40.74 | $42.66 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $28.84 Typical High $39.81 | Professional | 56 · Pre-op care only | $27.54 | $28.84 | $39.81 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $190.55 Median $199.53 Typical High $275.42 | Professional | 78 · Unplanned return to OR | $190.55 | $199.53 | $275.42 |
Where Florida sits
The same service costs 4.5 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 $4,914MT $1,099
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.