How much rates vary
Facilitymedian $5,012 · 10th to 90th $1,820 to $14,125Professionalmedian $437 · 10th to 90th $87 to $708
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 $776.25 Median $6,025.60 Typical High $12,302.69 | Facility | None | $776.25 | $6,025.60 | $12,302.69 |
Aetna Setting Professional Modifier None Typical Low $467.74 Median $489.78 Typical High $645.65 | Professional | None | $467.74 | $489.78 | $645.65 |
AvMed Setting Facility Modifier None Typical Low $501.19 Median $4,168.69 Typical High $11,748.98 | Facility | None | $501.19 | $4,168.69 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $467.74 Median $588.84 Typical High $676.08 | Professional | None | $467.74 | $588.84 | $676.08 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $4,365.16 Typical High $8,317.64 | Facility | None | $489.78 | $4,365.16 | $8,317.64 |
Cigna Setting Professional Modifier None Typical Low $398.11 Median $426.58 Typical High $870.96 | Professional | None | $398.11 | $426.58 | $870.96 |
Florida Blue Setting Facility Modifier None Typical Low $2,818.38 Median $5,495.41 Typical High $16,982.44 | Facility | None | $2,818.38 | $5,495.41 | $16,982.44 |
Florida Blue Setting Professional Modifier None Typical Low $239.88 Median $537.03 Typical High $741.31 | Professional | None | $239.88 | $537.03 | $741.31 |
Molina Setting Professional Modifier None Typical Low $60.26 Median $346.74 Typical High $676.08 | Professional | None | $60.26 | $346.74 | $676.08 |
United Setting Facility Modifier None Typical Low $1,584.89 Median $4,073.80 Typical High $15,488.17 | Facility | None | $1,584.89 | $4,073.80 | $15,488.17 |
United Setting Professional Modifier None Typical Low $371.54 Median $478.63 Typical High $912.01 | Professional | None | $371.54 | $478.63 | $912.01 |
Wellpoint Setting Professional Modifier None Typical Low $436.52 Median $436.52 Typical High $575.44 | Professional | None | $436.52 | $436.52 | $575.44 |
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 $234.42 Median $245.47 Typical High $288.40 | Professional | 52 · Reduced service | $234.42 | $245.47 | $288.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $97.72 Typical High $114.82 | Professional | 53 · Discontinued | $93.33 | $97.72 | $114.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $354.81 Median $363.08 Typical High $436.52 | Professional | 54 · Surgery only | $354.81 | $363.08 | $436.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $72.44 Typical High $87.10 | Professional | 55 · Aftercare only | $70.79 | $72.44 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $48.98 Typical High $57.54 | Professional | 56 · Pre-op care only | $46.77 | $48.98 | $57.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $331.13 Median $338.84 Typical High $407.38 | Professional | 78 · Unplanned return to OR | $331.13 | $338.84 | $407.38 |
Where Florida sits
The same service costs 6.5 times more in Alaska 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
AK $12,011MT $1,848
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.