How much rates vary
Facilitymedian $1,862 · 10th to 90th $776 to $11,749Professionalmedian $372 · 10th to 90th $76 to $589
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 $630.96 Median $4,677.35 Typical High $11,748.98 | Facility | None | $630.96 | $4,677.35 | $11,748.98 |
Aetna Setting Professional Modifier None Typical Low $380.19 Median $416.87 Typical High $549.54 | Professional | None | $380.19 | $416.87 | $549.54 |
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 $363.08 Median $478.63 Typical High $537.03 | Professional | None | $363.08 | $478.63 | $537.03 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $1,905.46 Typical High $2,884.03 | Facility | None | $501.19 | $1,905.46 | $2,884.03 |
Cigna Setting Professional Modifier None Typical Low $346.74 Median $363.08 Typical High $724.44 | Professional | None | $346.74 | $363.08 | $724.44 |
Florida Blue Setting Facility Modifier None Typical Low $870.96 Median $1,737.80 Typical High $16,982.44 | Facility | None | $870.96 | $1,737.80 | $16,982.44 |
Florida Blue Setting Professional Modifier None Typical Low $194.98 Median $416.87 Typical High $524.81 | Professional | None | $194.98 | $416.87 | $524.81 |
Molina Setting Professional Modifier None Typical Low $57.54 Median $338.84 Typical High $562.34 | Professional | None | $57.54 | $338.84 | $562.34 |
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 $316.23 Median $407.38 Typical High $794.33 | Professional | None | $316.23 | $407.38 | $794.33 |
Wellpoint Setting Professional Modifier None Typical Low $346.74 Median $346.74 Typical High $457.09 | Professional | None | $346.74 | $346.74 | $457.09 |
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 $190.55 Median $204.17 Typical High $251.19 | Professional | 52 · Reduced service | $190.55 | $204.17 | $251.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $83.18 Typical High $100.00 | Professional | 53 · Discontinued | $75.86 | $83.18 | $100.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $281.84 Median $309.03 Typical High $380.19 | Professional | 54 · Surgery only | $281.84 | $309.03 | $380.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $61.66 Typical High $75.86 | Professional | 55 · Aftercare only | $56.23 | $61.66 | $75.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $41.69 Typical High $50.12 | Professional | 56 · Pre-op care only | $38.02 | $41.69 | $50.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $263.03 Median $288.40 Typical High $354.81 | Professional | 78 · Unplanned return to OR | $263.03 | $288.40 | $354.81 |
Where Florida sits
The same service costs 4.6 times more in Alabama 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
AL $7,006MT $1,517
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.