How much rates vary
Facilitymedian $2,291 · 10th to 90th $1,000 to $12,023Professionalmedian $603 · 10th to 90th $89 to $977
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 $588.84 Median $630.96 Typical High $870.96 | Professional | None | $588.84 | $630.96 | $870.96 |
AvMed Setting Facility Modifier None Typical Low $630.96 Median $2,089.30 Typical High $9,772.37 | Facility | None | $630.96 | $2,089.30 | $9,772.37 |
AvMed Setting Professional Modifier None Typical Low $630.96 Median $794.33 Typical High $891.25 | Professional | None | $630.96 | $794.33 | $891.25 |
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 $575.44 Median $602.56 Typical High $1,148.15 | Professional | None | $575.44 | $602.56 | $1,148.15 |
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 $295.12 Median $676.08 Typical High $851.14 | Professional | None | $295.12 | $676.08 | $851.14 |
Molina Setting Professional Modifier None Typical Low $60.26 Median $512.86 Typical High $954.99 | Professional | None | $60.26 | $512.86 | $954.99 |
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 $512.86 Median $645.65 Typical High $1,258.93 | Professional | None | $512.86 | $645.65 | $1,258.93 |
Wellpoint Setting Professional Modifier None Typical Low $616.60 Median $616.60 Typical High $794.33 | Professional | None | $616.60 | $616.60 | $794.33 |
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 $288.40 Median $316.23 Typical High $426.58 | Professional | 52 · Reduced service | $288.40 | $316.23 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $117.49 Median $125.89 Typical High $169.82 | Professional | 53 · Discontinued | $117.49 | $125.89 | $169.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $436.52 Median $478.63 Typical High $645.65 | Professional | 54 · Surgery only | $436.52 | $478.63 | $645.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $87.10 Median $95.50 Typical High $128.82 | Professional | 55 · Aftercare only | $87.10 | $95.50 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $58.88 Median $63.10 Typical High $85.11 | Professional | 56 · Pre-op care only | $58.88 | $63.10 | $85.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $407.38 Median $446.68 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $407.38 | $446.68 | $602.56 |
Where Florida sits
The same service costs 3.1 times more in Wisconsin than in Hawaii. 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 $7,619HI $2,493
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.