How much rates vary
Facilitymedian $1,905 · 10th to 90th $776 to $9,772Professionalmedian $316 · 10th to 90th $234 to $631
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 $616.60 Median $4,677.35 Typical High $11,748.98 | Facility | None | $616.60 | $4,677.35 | $11,748.98 |
Aetna Setting Professional Modifier None Typical Low $316.23 Median $346.74 Typical High $588.84 | Professional | None | $316.23 | $346.74 | $588.84 |
Ambetter Setting Professional Modifier None Typical Low $162.18 Median $562.34 Typical High $660.69 | Professional | None | $162.18 | $562.34 | $660.69 |
AvMed Setting Facility Modifier None Typical Low $501.19 Median $2,089.30 Typical High $9,772.37 | Facility | None | $501.19 | $2,089.30 | $9,772.37 |
AvMed Setting Professional Modifier None Typical Low $257.04 Median $363.08 Typical High $676.08 | Professional | None | $257.04 | $363.08 | $676.08 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $1,445.44 Typical High $2,691.53 | Facility | None | $501.19 | $1,445.44 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $251.19 Median $263.03 Typical High $691.83 | Professional | None | $251.19 | $263.03 | $691.83 |
Florida Blue Setting Facility Modifier None Typical Low $912.01 Median $1,995.26 Typical High $11,748.98 | Facility | None | $912.01 | $1,995.26 | $11,748.98 |
Florida Blue Setting Professional Modifier None Typical Low $223.87 Median $346.74 Typical High $575.44 | Professional | None | $223.87 | $346.74 | $575.44 |
Molina Setting Professional Modifier None Typical Low $245.47 Median $295.12 Typical High $524.81 | Professional | None | $245.47 | $295.12 | $524.81 |
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 $234.42 Median $338.84 Typical High $741.31 | Professional | None | $234.42 | $338.84 | $741.31 |
Wellpoint Setting Professional Modifier None Typical Low $234.42 Median $234.42 Typical High $316.23 | Professional | None | $234.42 | $234.42 | $316.23 |
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 $154.88 Median $158.49 Typical High $257.04 | Professional | 52 · Reduced service | $154.88 | $158.49 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $63.10 Typical High $102.33 | Professional | 53 · Discontinued | $63.10 | $63.10 | $102.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $234.42 Median $239.88 Typical High $380.19 | Professional | 54 · Surgery only | $234.42 | $239.88 | $380.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $46.77 Median $47.86 Typical High $75.86 | Professional | 55 · Aftercare only | $46.77 | $47.86 | $75.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $31.62 Typical High $51.29 | Professional | 56 · Pre-op care only | $30.90 | $31.62 | $51.29 |
Where Florida sits
The same service costs 6.1 times more in Oklahoma 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
OK $6,602MT $1,074
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.