How much rates vary
Facilitymedian $4,786 · 10th to 90th $1,862 to $14,791Professionalmedian $3,981 · 10th to 90th $389 to $7,413
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 $758.58 Median $6,918.31 Typical High $19,054.61 | Facility | None | $758.58 | $6,918.31 | $19,054.61 |
Aetna Setting Professional Modifier None Typical Low $467.74 Median $1,698.24 Typical High $7,244.36 | Professional | None | $467.74 | $1,698.24 | $7,244.36 |
Ambetter Setting Professional Modifier None Typical Low $446.68 Median $5,248.07 Typical High $5,248.07 | Professional | None | $446.68 | $5,248.07 | $5,248.07 |
AvMed Setting Facility Modifier None Typical Low $891.25 Median $2,570.40 Typical High $10,232.93 | Facility | None | $891.25 | $2,570.40 | $10,232.93 |
AvMed Setting Professional Modifier None Typical Low $478.63 Median $4,786.30 Typical High $6,309.57 | Professional | None | $478.63 | $4,786.30 | $6,309.57 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $4,265.80 Typical High $9,332.54 | Facility | None | $501.19 | $4,265.80 | $9,332.54 |
Cigna Setting Professional Modifier None Typical Low $371.54 Median $1,288.25 Typical High $7,079.46 | Professional | None | $371.54 | $1,288.25 | $7,079.46 |
Florida Blue Setting Facility Modifier None Typical Low $2,630.27 Median $5,495.41 Typical High $16,982.44 | Facility | None | $2,630.27 | $5,495.41 | $16,982.44 |
Florida Blue Setting Professional Modifier None Typical Low $3,019.95 Median $5,370.32 Typical High $7,585.78 | Professional | None | $3,019.95 | $5,370.32 | $7,585.78 |
Molina Setting Professional Modifier None Typical Low $467.74 Median $4,365.16 Typical High $7,413.10 | Professional | None | $467.74 | $4,365.16 | $7,413.10 |
United Setting Facility Modifier None Typical Low $1,659.59 Median $4,897.79 Typical High $19,498.45 | Facility | None | $1,659.59 | $4,897.79 | $19,498.45 |
United Setting Professional Modifier None Typical Low $380.19 Median $3,630.78 Typical High $8,709.64 | Professional | None | $380.19 | $3,630.78 | $8,709.64 |
Wellpoint Setting Professional Modifier None Typical Low $354.81 Median $4,466.84 Typical High $4,466.84 | Professional | None | $354.81 | $4,466.84 | $4,466.84 |
7 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 $549.54 Typical High $3,090.30 | Professional | 52 · Reduced service | $234.42 | $549.54 | $3,090.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $223.87 Typical High $1,230.27 | Professional | 53 · Discontinued | $93.33 | $223.87 | $1,230.27 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $354.81 Median $831.76 Typical High $4,570.88 | Professional | 54 · Surgery only | $354.81 | $831.76 | $4,570.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $165.96 Typical High $912.01 | Professional | 55 · Aftercare only | $70.79 | $165.96 | $912.01 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $109.65 Typical High $616.60 | Professional | 56 · Pre-op care only | $46.77 | $109.65 | $616.60 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $331.13 Median $776.25 Typical High $4,265.80 | Professional | 78 · Unplanned return to OR | $331.13 | $776.25 | $4,265.80 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $5,248.07 Median $5,248.07 Typical High $5,248.07 | Professional | 59 · Distinct service | $5,248.07 | $5,248.07 | $5,248.07 |
Where Florida sits
The same service costs 5.8 times more in Oklahoma than in Mississippi. 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 $20,151MS $3,493
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.