How much rates vary
Facilitymedian $129 · 10th to 90th $39 to $3,548Professionalmedian $135 · 10th to 90th $74 to $234
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 $199.53 Median $2,884.03 Typical High $10,964.78 | Facility | None | $199.53 | $2,884.03 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $83.18 Median $138.04 Typical High $204.17 | Professional | None | $83.18 | $138.04 | $204.17 |
Ambetter Setting Professional Modifier None Typical Low $169.82 Median $169.82 Typical High $169.82 | Professional | None | $169.82 | $169.82 | $169.82 |
AvMed Setting Facility Modifier None Typical Low $112.20 Median $2,137.96 Typical High $11,748.98 | Facility | None | $112.20 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $102.33 Median $177.83 Typical High $239.88 | Professional | None | $102.33 | $177.83 | $239.88 |
Cigna Setting Facility Modifier None Typical Low $52.48 Median $123.03 Typical High $234.42 | Facility | None | $52.48 | $123.03 | $234.42 |
Cigna Setting Professional Modifier None Typical Low $74.13 Median $123.03 Typical High $208.93 | Professional | None | $74.13 | $123.03 | $208.93 |
Florida Blue Setting Facility Modifier None Typical Low $34.67 Median $75.86 Typical High $3,019.95 | Facility | None | $34.67 | $75.86 | $3,019.95 |
Florida Blue Setting Professional Modifier None Typical Low $147.91 Median $169.82 Typical High $257.04 | Professional | None | $147.91 | $169.82 | $257.04 |
Molina Setting Professional Modifier None Typical Low $77.62 Median $165.96 Typical High $263.03 | Professional | None | $77.62 | $165.96 | $263.03 |
United Setting Facility Modifier None Typical Low $81.28 Median $302.00 Typical High $2,754.23 | Facility | None | $81.28 | $302.00 | $2,754.23 |
United Setting Professional Modifier None Typical Low $67.61 Median $125.89 Typical High $251.19 | Professional | None | $67.61 | $125.89 | $251.19 |
Wellpoint Setting Professional Modifier None Typical Low $70.79 Median $144.54 Typical High $144.54 | Professional | None | $70.79 | $144.54 | $144.54 |
5 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 $40.74 Median $69.18 Typical High $102.33 | Professional | 52 · Reduced service | $40.74 | $69.18 | $102.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.22 Median $27.54 Typical High $40.74 | Professional | 53 · Discontinued | $16.22 | $27.54 | $40.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $60.26 Median $104.71 Typical High $151.36 | Professional | 54 · Surgery only | $60.26 | $104.71 | $151.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $20.89 Typical High $30.90 | Professional | 55 · Aftercare only | $12.02 | $20.89 | $30.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.13 Median $13.80 Typical High $20.42 | Professional | 56 · Pre-op care only | $8.13 | $13.80 | $20.42 |
Where Florida sits
The same service costs 11.6 times more in Hawaii than in Maryland. 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
HI $3,027MD $261
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.