How much rates vary
Facilitymedian $2,344 · 10th to 90th $1,000 to $12,023Professionalmedian $676 · 10th to 90th $93 to $1,096
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 $776.25 Median $5,888.44 Typical High $12,022.64 | Facility | None | $776.25 | $5,888.44 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $676.08 Median $794.33 Typical High $1,000.00 | Professional | None | $676.08 | $794.33 | $1,000.00 |
AvMed Setting Facility Modifier None Typical Low $691.83 Median $2,137.96 Typical High $9,772.37 | Facility | None | $691.83 | $2,137.96 | $9,772.37 |
AvMed Setting Professional Modifier None Typical Low $691.83 Median $870.96 Typical High $1,000.00 | Professional | None | $691.83 | $870.96 | $1,000.00 |
Cigna Setting Facility Modifier None Typical Low $616.60 Median $1,905.46 Typical High $3,311.31 | Facility | None | $616.60 | $1,905.46 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $645.65 Median $676.08 Typical High $1,348.96 | Professional | None | $645.65 | $676.08 | $1,348.96 |
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 $346.74 Median $776.25 Typical High $1,000.00 | Professional | None | $346.74 | $776.25 | $1,000.00 |
Molina Setting Professional Modifier None Typical Low $60.26 Median $575.44 Typical High $1,023.29 | Professional | None | $60.26 | $575.44 | $1,023.29 |
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 $588.84 Median $758.58 Typical High $1,479.11 | Professional | None | $588.84 | $758.58 | $1,479.11 |
Wellpoint Setting Professional Modifier None Typical Low $660.69 Median $660.69 Typical High $870.96 | Professional | None | $660.69 | $660.69 | $870.96 |
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 $338.84 Median $389.05 Typical High $467.74 | Professional | 52 · Reduced service | $338.84 | $389.05 | $467.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $158.49 Typical High $190.55 | Professional | 53 · Discontinued | $134.90 | $158.49 | $190.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $588.84 Typical High $707.95 | Professional | 54 · Surgery only | $501.19 | $588.84 | $707.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $117.49 Typical High $141.25 | Professional | 55 · Aftercare only | $100.00 | $117.49 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $79.43 Typical High $95.50 | Professional | 56 · Pre-op care only | $67.61 | $79.43 | $95.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $467.74 Median $549.54 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $467.74 | $549.54 | $660.69 |
Ambetter Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,148.15 Median $1,148.15 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $1,148.15 | $1,148.15 | $1,148.15 |
Where Florida sits
The same service costs 3.0 times more in Wisconsin than in Maryland. 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
WI $7,993MD $2,690
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.