How much rates vary
Facilitymedian $1,047 · 10th to 90th $251 to $7,586Professionalmedian $257 · 10th to 90th $170 to $417
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 $478.63 Median $3,090.30 Typical High $10,964.78 | Facility | None | $478.63 | $3,090.30 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $190.55 Median $257.04 Typical High $380.19 | Professional | None | $190.55 | $257.04 | $380.19 |
Ambetter Setting Professional Modifier None Typical Low $181.97 Median $181.97 Typical High $281.84 | Professional | None | $181.97 | $181.97 | $281.84 |
AvMed Setting Facility Modifier None Typical Low $309.03 Median $2,137.96 Typical High $11,748.98 | Facility | None | $309.03 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $218.78 Median $309.03 Typical High $407.38 | Professional | None | $218.78 | $309.03 | $407.38 |
Cigna Setting Facility Modifier None Typical Low $407.38 Median $1,288.25 Typical High $2,089.30 | Facility | None | $407.38 | $1,288.25 | $2,089.30 |
Cigna Setting Professional Modifier None Typical Low $169.82 Median $245.47 Typical High $398.11 | Professional | None | $169.82 | $245.47 | $398.11 |
Florida Blue Setting Facility Modifier None Typical Low $218.78 Median $575.44 Typical High $8,511.38 | Facility | None | $218.78 | $575.44 | $8,511.38 |
Florida Blue Setting Professional Modifier None Typical Low $257.04 Median $281.84 Typical High $416.87 | Professional | None | $257.04 | $281.84 | $416.87 |
Molina Setting Professional Modifier None Typical Low $169.82 Median $338.84 Typical High $489.78 | Professional | None | $169.82 | $338.84 | $489.78 |
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 $169.82 Median $257.04 Typical High $467.74 | Professional | None | $169.82 | $257.04 | $467.74 |
Wellpoint Setting Professional Modifier None Typical Low $154.88 Median $281.84 Typical High $281.84 | Professional | None | $154.88 | $281.84 | $281.84 |
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 $95.50 Median $128.82 Typical High $141.25 | Professional | 52 · Reduced service | $95.50 | $128.82 | $141.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $51.29 Typical High $57.54 | Professional | 53 · Discontinued | $38.02 | $51.29 | $57.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $144.54 Median $194.98 Typical High $213.80 | Professional | 54 · Surgery only | $144.54 | $194.98 | $213.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $38.90 Typical High $42.66 | Professional | 55 · Aftercare only | $28.84 | $38.90 | $42.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $25.70 Typical High $28.18 | Professional | 56 · Pre-op care only | $19.05 | $25.70 | $28.18 |
Where Florida sits
The same service costs 6.1 times more in Michigan 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
MI $4,783MT $790
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.