How much rates vary
Facilitymedian $2,291 · 10th to 90th $1,000 to $12,023Professionalmedian $427 · 10th to 90th $78 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 $630.96 Median $4,786.30 Typical High $11,748.98 | Facility | None | $630.96 | $4,786.30 | $11,748.98 |
Aetna Setting Professional Modifier None Typical Low $478.63 Median $489.78 Typical High $645.65 | Professional | None | $478.63 | $489.78 | $645.65 |
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 $436.52 Median $588.84 Typical High $676.08 | Professional | None | $436.52 | $588.84 | $676.08 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $1,905.46 Typical High $2,951.21 | Facility | None | $501.19 | $1,905.46 | $2,951.21 |
Cigna Setting Professional Modifier None Typical Low $407.38 Median $426.58 Typical High $891.25 | Professional | None | $407.38 | $426.58 | $891.25 |
Florida Blue Setting Facility Modifier None Typical Low $1,230.27 Median $2,630.27 Typical High $16,982.44 | Facility | None | $1,230.27 | $2,630.27 | $16,982.44 |
Florida Blue Setting Professional Modifier None Typical Low $239.88 Median $524.81 Typical High $794.33 | Professional | None | $239.88 | $524.81 | $794.33 |
Molina Setting Professional Modifier None Typical Low $60.26 Median $346.74 Typical High $630.96 | Professional | None | $60.26 | $346.74 | $630.96 |
United Setting Facility Modifier None Typical Low $954.99 Median $2,344.23 Typical High $10,000.00 | Facility | None | $954.99 | $2,344.23 | $10,000.00 |
United Setting Professional Modifier None Typical Low $371.54 Median $501.19 Typical High $954.99 | Professional | None | $371.54 | $501.19 | $954.99 |
Wellpoint Setting Professional Modifier None Typical Low $416.87 Median $416.87 Typical High $549.54 | Professional | None | $416.87 | $416.87 | $549.54 |
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 $239.88 Median $245.47 Typical High $309.03 | Professional | 52 · Reduced service | $239.88 | $245.47 | $309.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $97.72 Typical High $123.03 | Professional | 53 · Discontinued | $95.50 | $97.72 | $123.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $354.81 Median $363.08 Typical High $457.09 | Professional | 54 · Surgery only | $354.81 | $363.08 | $457.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $72.44 Typical High $93.33 | Professional | 55 · Aftercare only | $70.79 | $72.44 | $93.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $48.98 Typical High $61.66 | Professional | 56 · Pre-op care only | $47.86 | $48.98 | $61.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $331.13 Median $338.84 Typical High $426.58 | Professional | 78 · Unplanned return to OR | $331.13 | $338.84 | $426.58 |
Where Florida sits
The same service costs 4.1 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 $7,594MT $1,845
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.