How much rates vary
Facilitymedian $1,660 · 10th to 90th $646 to $8,128Professionalmedian $631 · 10th to 90th $204 to $1,023
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 $630.96 Median $4,365.16 Typical High $11,748.98 | Facility | None | $630.96 | $4,365.16 | $11,748.98 |
Aetna Setting Professional Modifier None Typical Low $537.03 Median $645.65 Typical High $891.25 | Professional | None | $537.03 | $645.65 | $891.25 |
AvMed Setting Facility Modifier None Typical Low $645.65 Median $1,905.46 Typical High $9,549.93 | Facility | None | $645.65 | $1,905.46 | $9,549.93 |
AvMed Setting Professional Modifier None Typical Low $645.65 Median $741.31 Typical High $977.24 | Professional | None | $645.65 | $741.31 | $977.24 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $1,318.26 Typical High $2,691.53 | Facility | None | $501.19 | $1,318.26 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $501.19 Median $630.96 Typical High $1,023.29 | Professional | None | $501.19 | $630.96 | $1,023.29 |
Florida Blue Setting Facility Modifier None Typical Low $660.69 Median $1,659.59 Typical High $8,511.38 | Facility | None | $660.69 | $1,659.59 | $8,511.38 |
Florida Blue Setting Professional Modifier None Typical Low $616.60 Median $676.08 Typical High $1,000.00 | Professional | None | $616.60 | $676.08 | $1,000.00 |
Molina Setting Professional Modifier None Typical Low $112.20 Median $630.96 Typical High $1,023.29 | Professional | None | $112.20 | $630.96 | $1,023.29 |
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 $446.68 Median $630.96 Typical High $1,148.15 | Professional | None | $446.68 | $630.96 | $1,148.15 |
Wellpoint Setting Professional Modifier None Typical Low $467.74 Median $676.08 Typical High $676.08 | Professional | None | $467.74 | $676.08 | $676.08 |
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 $269.15 Median $316.23 Typical High $363.08 | Professional | 52 · Reduced service | $269.15 | $316.23 | $363.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $128.82 Typical High $144.54 | Professional | 53 · Discontinued | $107.15 | $128.82 | $144.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $398.11 Median $478.63 Typical High $537.03 | Professional | 54 · Surgery only | $398.11 | $478.63 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $95.50 Typical High $107.15 | Professional | 55 · Aftercare only | $81.28 | $95.50 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $63.10 Typical High $72.44 | Professional | 56 · Pre-op care only | $53.70 | $63.10 | $72.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $371.54 Median $446.68 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $371.54 | $446.68 | $501.19 |
Where Florida sits
The same service costs 3.1 times more in Alaska 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
AK $5,990MD $1,938
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.