How much rates vary
Facilitymedian $2,399 · 10th to 90th $1,072 to $13,183Professionalmedian $646 · 10th to 90th $110 to $1,023
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 $691.83 Median $4,786.30 Typical High $11,748.98 | Facility | None | $691.83 | $4,786.30 | $11,748.98 |
Aetna Setting Professional Modifier None Typical Low $660.69 Median $724.44 Typical High $954.99 | Professional | None | $660.69 | $724.44 | $954.99 |
AvMed Setting Facility Modifier None Typical Low $676.08 Median $2,089.30 Typical High $9,772.37 | Facility | None | $676.08 | $2,089.30 | $9,772.37 |
AvMed Setting Professional Modifier None Typical Low $676.08 Median $851.14 Typical High $954.99 | Professional | None | $676.08 | $851.14 | $954.99 |
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 $331.13 Median $758.58 Typical High $977.24 | Professional | None | $331.13 | $758.58 | $977.24 |
Molina Setting Professional Modifier None Typical Low $91.20 Median $537.03 Typical High $977.24 | Professional | None | $91.20 | $537.03 | $977.24 |
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 $562.34 Median $724.44 Typical High $1,380.38 | Professional | None | $562.34 | $724.44 | $1,380.38 |
Wellpoint Setting Professional Modifier None Typical Low $645.65 Median $645.65 Typical High $831.76 | Professional | None | $645.65 | $645.65 | $831.76 |
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 $323.59 Median $363.08 Typical High $467.74 | Professional | 52 · Reduced service | $323.59 | $363.08 | $467.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $144.54 Typical High $186.21 | Professional | 53 · Discontinued | $131.83 | $144.54 | $186.21 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $537.03 Typical High $707.95 | Professional | 54 · Surgery only | $489.78 | $537.03 | $707.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $107.15 Typical High $141.25 | Professional | 55 · Aftercare only | $97.72 | $107.15 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $72.44 Typical High $93.33 | Professional | 56 · Pre-op care only | $66.07 | $72.44 | $93.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $457.09 Median $501.19 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $457.09 | $501.19 | $660.69 |
Where Florida sits
The same service costs 3.4 times more in Wisconsin than in Kansas. 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 $8,857KS $2,587
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.