How much rates vary
Facilitymedian $251 · 10th to 90th $72 to $3,388Professionalmedian $398 · 10th to 90th $87 to $646
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 $398.11 Median $3,019.95 Typical High $10,964.78 | Facility | None | $398.11 | $3,019.95 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $354.81 Median $398.11 Typical High $562.34 | Professional | None | $354.81 | $398.11 | $562.34 |
Ambetter Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $524.81 | Professional | None | $524.81 | $524.81 | $524.81 |
AvMed Setting Facility Modifier None Typical Low $131.83 Median $954.99 Typical High $9,549.93 | Facility | None | $131.83 | $954.99 | $9,549.93 |
AvMed Setting Professional Modifier None Typical Low $436.52 Median $489.78 Typical High $575.44 | Professional | None | $436.52 | $489.78 | $575.44 |
Cigna Setting Facility Modifier None Typical Low $131.83 Median $281.84 Typical High $1,659.59 | Facility | None | $131.83 | $281.84 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $331.13 Median $380.19 Typical High $691.83 | Professional | None | $331.13 | $380.19 | $691.83 |
Florida Blue Setting Facility Modifier None Typical Low $64.57 Median $131.83 Typical High $3,019.95 | Facility | None | $64.57 | $131.83 | $3,019.95 |
Florida Blue Setting Professional Modifier None Typical Low $190.55 Median $436.52 Typical High $588.84 | Professional | None | $190.55 | $436.52 | $588.84 |
Molina Setting Professional Modifier None Typical Low $61.66 Median $371.54 Typical High $630.96 | Professional | None | $61.66 | $371.54 | $630.96 |
United Setting Facility Modifier None Typical Low $81.28 Median $302.00 Typical High $2,818.38 | Facility | None | $81.28 | $302.00 | $2,818.38 |
United Setting Professional Modifier None Typical Low $302.00 Median $407.38 Typical High $794.33 | Professional | None | $302.00 | $407.38 | $794.33 |
Wellpoint Setting Professional Modifier None Typical Low $354.81 Median $426.58 Typical High $426.58 | Professional | None | $354.81 | $426.58 | $426.58 |
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 $173.78 Median $199.53 Typical High $257.04 | Professional | 52 · Reduced service | $173.78 | $199.53 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $79.43 Typical High $102.33 | Professional | 53 · Discontinued | $70.79 | $79.43 | $102.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $295.12 Typical High $389.05 | Professional | 54 · Surgery only | $263.03 | $295.12 | $389.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $58.88 Typical High $77.62 | Professional | 55 · Aftercare only | $52.48 | $58.88 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $39.81 Typical High $51.29 | Professional | 56 · Pre-op care only | $35.48 | $39.81 | $51.29 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $245.47 Median $275.42 Typical High $363.08 | Professional | 78 · Unplanned return to OR | $245.47 | $275.42 | $363.08 |
Where Florida sits
The same service costs 4.7 times more in New York than in Florida. 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
NY $3,038FL $649
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.