How much rates vary
Facilitymedian $2,818 · 10th to 90th $1,047 to $14,454Professionalmedian $1,479 · 10th to 90th $275 to $2,455
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 $851.14 Median $6,025.60 Typical High $13,182.57 | Facility | None | $851.14 | $6,025.60 | $13,182.57 |
Aetna Setting Professional Modifier None Typical Low $1,412.54 Median $1,862.09 Typical High $2,290.87 | Professional | None | $1,412.54 | $1,862.09 | $2,290.87 |
AvMed Setting Facility Modifier None Typical Low $1,445.44 Median $3,467.37 Typical High $11,748.98 | Facility | None | $1,445.44 | $3,467.37 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $1,047.13 Median $1,905.46 Typical High $2,344.23 | Professional | None | $1,047.13 | $1,905.46 | $2,344.23 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $3,548.13 Typical High $6,606.93 | Facility | None | $512.86 | $3,548.13 | $6,606.93 |
Cigna Setting Professional Modifier None Typical Low $1,380.38 Median $1,584.89 Typical High $3,019.95 | Professional | None | $1,380.38 | $1,584.89 | $3,019.95 |
Florida Blue Setting Facility Modifier None Typical Low $1,071.52 Median $2,238.72 Typical High $16,982.44 | Facility | None | $1,071.52 | $2,238.72 | $16,982.44 |
Florida Blue Setting Professional Modifier None Typical Low $794.33 Median $1,348.96 Typical High $2,089.30 | Professional | None | $794.33 | $1,348.96 | $2,089.30 |
Molina Setting Professional Modifier None Typical Low $204.17 Median $1,230.27 Typical High $2,238.72 | Professional | None | $204.17 | $1,230.27 | $2,238.72 |
United Setting Facility Modifier None Typical Low $1,584.89 Median $4,073.80 Typical High $15,488.17 | Facility | None | $1,584.89 | $4,073.80 | $15,488.17 |
United Setting Professional Modifier None Typical Low $831.76 Median $1,659.59 Typical High $3,467.37 | Professional | None | $831.76 | $1,659.59 | $3,467.37 |
Wellpoint Setting Professional Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $1,905.46 | Professional | None | $1,096.48 | $1,096.48 | $1,905.46 |
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 $707.95 Median $933.25 Typical High $1,122.02 | Professional | 52 · Reduced service | $707.95 | $933.25 | $1,122.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $281.84 Median $371.54 Typical High $446.68 | Professional | 53 · Discontinued | $281.84 | $371.54 | $446.68 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,071.52 Median $1,380.38 Typical High $1,659.59 | Professional | 54 · Surgery only | $1,071.52 | $1,380.38 | $1,659.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $213.80 Median $281.84 Typical High $331.13 | Professional | 55 · Aftercare only | $213.80 | $281.84 | $331.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $141.25 Median $186.21 Typical High $223.87 | Professional | 56 · Pre-op care only | $141.25 | $186.21 | $223.87 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,000.00 Median $1,288.25 Typical High $1,548.82 | Professional | 78 · Unplanned return to OR | $1,000.00 | $1,288.25 | $1,548.82 |
Where Florida sits
The same service costs 4.9 times more in Alaska than in Kentucky. 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
AK $18,090KY $3,723
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.