How much rates vary
Facilitymedian $3,311 · 10th to 90th $1,259 to $14,125Professionalmedian $1,950 · 10th to 90th $347 to $3,090
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 $851.14 Median $6,025.60 Typical High $13,182.57 | Facility | None | $851.14 | $6,025.60 | $13,182.57 |
Aetna Setting Professional Modifier None Typical Low $1,949.84 Median $2,290.87 Typical High $2,691.53 | Professional | None | $1,949.84 | $2,290.87 | $2,691.53 |
AvMed Setting Facility Modifier None Typical Low $1,445.44 Median $3,467.37 Typical High $11,748.98 | Facility | None | $1,445.44 | $3,467.37 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $1,949.84 Median $2,454.71 Typical High $2,951.21 | Professional | None | $1,949.84 | $2,454.71 | $2,951.21 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $3,467.37 Typical High $6,606.93 | Facility | None | $489.78 | $3,467.37 | $6,606.93 |
Cigna Setting Professional Modifier None Typical Low $1,819.70 Median $1,949.84 Typical High $3,801.89 | Professional | None | $1,819.70 | $1,949.84 | $3,801.89 |
Florida Blue Setting Facility Modifier None Typical Low $1,318.26 Median $2,630.27 Typical High $16,982.44 | Facility | None | $1,318.26 | $2,630.27 | $16,982.44 |
Florida Blue Setting Professional Modifier None Typical Low $1,000.00 Median $2,187.76 Typical High $2,630.27 | Professional | None | $1,000.00 | $2,187.76 | $2,630.27 |
Molina Setting Professional Modifier None Typical Low $229.09 Median $1,584.89 Typical High $2,818.38 | Professional | None | $229.09 | $1,584.89 | $2,818.38 |
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 $1,737.80 Median $2,187.76 Typical High $4,365.16 | Professional | None | $1,737.80 | $2,187.76 | $4,365.16 |
Wellpoint Setting Professional Modifier None Typical Low $1,778.28 Median $1,778.28 Typical High $2,454.71 | Professional | None | $1,778.28 | $1,778.28 | $2,454.71 |
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 $977.24 Median $1,148.15 Typical High $1,348.96 | Professional | 52 · Reduced service | $977.24 | $1,148.15 | $1,348.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $389.05 Median $457.09 Typical High $537.03 | Professional | 53 · Discontinued | $389.05 | $457.09 | $537.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,479.11 Median $1,698.24 Typical High $1,995.26 | Professional | 54 · Surgery only | $1,479.11 | $1,698.24 | $1,995.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $295.12 Median $346.74 Typical High $398.11 | Professional | 55 · Aftercare only | $295.12 | $346.74 | $398.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $194.98 Median $229.09 Typical High $269.15 | Professional | 56 · Pre-op care only | $194.98 | $229.09 | $269.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,380.38 Median $1,584.89 Typical High $1,862.09 | Professional | 78 · Unplanned return to OR | $1,380.38 | $1,584.89 | $1,862.09 |
Where Florida sits
The same service costs 4.0 times more in Alaska than in Texas. 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 $19,772TX $4,915
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.