How much rates vary
Facilitymedian $1,585 · 10th to 90th $646 to $7,413Professionalmedian $229 · 10th to 90th $120 to $372
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 $426.58 Median $3,311.31 Typical High $10,964.78 | Facility | None | $426.58 | $3,311.31 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $134.90 Median $251.19 Typical High $338.84 | Professional | None | $134.90 | $251.19 | $338.84 |
Ambetter Setting Professional Modifier None Typical Low $75.86 Median $158.49 Typical High $323.59 | Professional | None | $75.86 | $158.49 | $323.59 |
AvMed Setting Facility Modifier None Typical Low $354.81 Median $1,479.11 Typical High $9,549.93 | Facility | None | $354.81 | $1,479.11 | $9,549.93 |
AvMed Setting Professional Modifier None Typical Low $158.49 Median $257.04 Typical High $338.84 | Professional | None | $158.49 | $257.04 | $338.84 |
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 $125.89 Median $229.09 Typical High $371.54 | Professional | None | $125.89 | $229.09 | $371.54 |
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 $123.03 Median $239.88 Typical High $371.54 | Professional | None | $123.03 | $239.88 | $371.54 |
Molina Setting Professional Modifier None Typical Low $28.18 Median $229.09 Typical High $416.87 | Professional | None | $28.18 | $229.09 | $416.87 |
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 $125.89 Median $223.87 Typical High $398.11 | Professional | None | $125.89 | $223.87 | $398.11 |
Wellpoint Setting Professional Modifier None Typical Low $125.89 Median $302.00 Typical High $302.00 | Professional | None | $125.89 | $302.00 | $302.00 |
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 $67.61 Median $125.89 Typical High $141.25 | Professional | 52 · Reduced service | $67.61 | $125.89 | $141.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.92 Median $50.12 Typical High $56.23 | Professional | 53 · Discontinued | $26.92 | $50.12 | $56.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $102.33 Median $186.21 Typical High $213.80 | Professional | 54 · Surgery only | $102.33 | $186.21 | $213.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.42 Median $38.02 Typical High $42.66 | Professional | 55 · Aftercare only | $20.42 | $38.02 | $42.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.49 Median $25.12 Typical High $28.18 | Professional | 56 · Pre-op care only | $13.49 | $25.12 | $28.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $95.50 Median $173.78 Typical High $199.53 | Professional | 78 · Unplanned return to OR | $95.50 | $173.78 | $199.53 |
Where Florida sits
The same service costs 6.3 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 $4,654MT $736
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.