How much rates vary
Facilitymedian $1,905 · 10th to 90th $562 to $13,490Professionalmedian $661 · 10th to 90th $110 to $1,000
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 $660.69 Median $3,311.31 Typical High $11,481.54 | Facility | None | $660.69 | $3,311.31 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $660.69 Median $707.95 Typical High $1,122.02 | Professional | None | $660.69 | $707.95 | $1,122.02 |
Ambetter Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $891.25 | Professional | None | $691.83 | $691.83 | $891.25 |
AvMed Setting Facility Modifier None Typical Low $512.86 Median $1,819.70 Typical High $9,549.93 | Facility | None | $512.86 | $1,819.70 | $9,549.93 |
AvMed Setting Professional Modifier None Typical Low $616.60 Median $794.33 Typical High $912.01 | Professional | None | $616.60 | $794.33 | $912.01 |
Cigna Setting Facility Modifier None Typical Low $436.52 Median $2,089.30 Typical High $3,467.37 | Facility | None | $436.52 | $2,089.30 | $3,467.37 |
Cigna Setting Professional Modifier None Typical Low $575.44 Median $660.69 Typical High $1,202.26 | Professional | None | $575.44 | $660.69 | $1,202.26 |
Florida Blue Setting Facility Modifier None Typical Low $912.01 Median $2,238.72 Typical High $18,197.01 | Facility | None | $912.01 | $2,238.72 | $18,197.01 |
Florida Blue Setting Professional Modifier None Typical Low $537.03 Median $602.56 Typical High $891.25 | Professional | None | $537.03 | $602.56 | $891.25 |
Molina Setting Professional Modifier None Typical Low $72.44 Median $549.54 Typical High $870.96 | Professional | None | $72.44 | $549.54 | $870.96 |
United Setting Facility Modifier None Typical Low $398.11 Median $1,000.00 Typical High $5,623.41 | Facility | None | $398.11 | $1,000.00 | $5,623.41 |
United Setting Professional Modifier None Typical Low $478.63 Median $691.83 Typical High $1,230.27 | Professional | None | $478.63 | $691.83 | $1,230.27 |
Wellpoint Setting Professional Modifier None Typical Low $575.44 Median $575.44 Typical High $758.58 | Professional | None | $575.44 | $575.44 | $758.58 |
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 $331.13 Median $354.81 Typical High $363.08 | Professional | 52 · Reduced service | $331.13 | $354.81 | $363.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $144.54 Typical High $144.54 | Professional | 53 · Discontinued | $131.83 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $537.03 Typical High $549.54 | Professional | 54 · Surgery only | $489.78 | $537.03 | $549.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $107.15 Typical High $109.65 | Professional | 55 · Aftercare only | $97.72 | $107.15 | $109.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $70.79 Typical High $72.44 | Professional | 56 · Pre-op care only | $66.07 | $70.79 | $72.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $457.09 Median $501.19 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $457.09 | $501.19 | $512.86 |
Where Florida sits
The same service costs 3.5 times more in Alaska than in Georgia. 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
AK $7,038GA $2,000
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.