How much rates vary
Facilitymedian $2,138 · 10th to 90th $912 to $11,749Professionalmedian $363 · 10th to 90th $78 to $589
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 $5,495.41 Typical High $14,791.08 | Facility | None | $776.25 | $5,495.41 | $14,791.08 |
Aetna Setting Professional Modifier None Typical Low $363.08 Median $407.38 Typical High $602.56 | Professional | None | $363.08 | $407.38 | $602.56 |
Ambetter Setting Professional Modifier None Typical Low $489.78 Median $630.96 Typical High $812.83 | Professional | None | $489.78 | $630.96 | $812.83 |
AvMed Setting Facility Modifier None Typical Low $512.86 Median $2,951.21 Typical High $9,549.93 | Facility | None | $512.86 | $2,951.21 | $9,549.93 |
AvMed Setting Professional Modifier None Typical Low $371.54 Median $467.74 Typical High $524.81 | Professional | None | $371.54 | $467.74 | $524.81 |
Cigna Setting Facility Modifier None Typical Low $977.24 Median $1,949.84 Typical High $5,248.07 | Facility | None | $977.24 | $1,949.84 | $5,248.07 |
Cigna Setting Professional Modifier None Typical Low $338.84 Median $363.08 Typical High $724.44 | Professional | None | $338.84 | $363.08 | $724.44 |
Florida Blue Setting Facility Modifier None Typical Low $1,000.00 Median $2,089.30 Typical High $16,982.44 | Facility | None | $1,000.00 | $2,089.30 | $16,982.44 |
Florida Blue Setting Professional Modifier None Typical Low $186.21 Median $426.58 Typical High $501.19 | Professional | None | $186.21 | $426.58 | $501.19 |
Molina Setting Professional Modifier None Typical Low $60.26 Median $309.03 Typical High $524.81 | Professional | None | $60.26 | $309.03 | $524.81 |
United Setting Facility Modifier None Typical Low $794.33 Median $1,778.28 Typical High $7,585.78 | Facility | None | $794.33 | $1,778.28 | $7,585.78 |
United Setting Professional Modifier None Typical Low $309.03 Median $398.11 Typical High $776.25 | Professional | None | $309.03 | $398.11 | $776.25 |
Wellpoint Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $467.74 | Professional | None | $354.81 | $354.81 | $467.74 |
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 $181.97 Median $204.17 Typical High $257.04 | Professional | 52 · Reduced service | $181.97 | $204.17 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $72.44 Median $83.18 Typical High $102.33 | Professional | 53 · Discontinued | $72.44 | $83.18 | $102.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $275.42 Median $309.03 Typical High $380.19 | Professional | 54 · Surgery only | $275.42 | $309.03 | $380.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $61.66 Typical High $75.86 | Professional | 55 · Aftercare only | $54.95 | $61.66 | $75.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $40.74 Typical High $51.29 | Professional | 56 · Pre-op care only | $36.31 | $40.74 | $51.29 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $257.04 Median $288.40 Typical High $354.81 | Professional | 78 · Unplanned return to OR | $257.04 | $288.40 | $354.81 |
Where Florida sits
The same service costs 5.4 times more in Alabama 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
AL $8,312MT $1,553
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.