How much rates vary
Facilitymedian $5,129 · 10th to 90th $794 to $15,488Professionalmedian $1,202 · 10th to 90th $182 to $1,905
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 $4,786.30 Typical High $11,748.98 | Facility | None | $776.25 | $4,786.30 | $11,748.98 |
Aetna Setting Professional Modifier None Typical Low $1,318.26 Median $1,445.44 Typical High $1,862.09 | Professional | None | $1,318.26 | $1,445.44 | $1,862.09 |
Ambetter Setting Professional Modifier None Typical Low $97.72 Median $707.95 Typical High $707.95 | Professional | None | $97.72 | $707.95 | $707.95 |
AvMed Setting Facility Modifier None Typical Low $1,202.26 Median $4,265.80 Typical High $13,182.57 | Facility | None | $1,202.26 | $4,265.80 | $13,182.57 |
AvMed Setting Professional Modifier None Typical Low $1,202.26 Median $1,584.89 Typical High $1,819.70 | Professional | None | $1,202.26 | $1,584.89 | $1,819.70 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $6,309.57 Typical High $12,302.69 | Facility | None | $512.86 | $6,309.57 | $12,302.69 |
Cigna Setting Professional Modifier None Typical Low $1,148.15 Median $1,230.27 Typical High $2,454.71 | Professional | None | $1,148.15 | $1,230.27 | $2,454.71 |
Florida Blue Setting Facility Modifier None Typical Low $4,168.69 Median $12,302.69 Typical High $22,908.68 | Facility | None | $4,168.69 | $12,302.69 | $22,908.68 |
Florida Blue Setting Professional Modifier None Typical Low $676.08 Median $1,412.54 Typical High $1,737.80 | Professional | None | $676.08 | $1,412.54 | $1,737.80 |
Molina Setting Professional Modifier None Typical Low $147.91 Median $912.01 Typical High $1,737.80 | Professional | None | $147.91 | $912.01 | $1,737.80 |
United Setting Facility Modifier None Typical Low $794.33 Median $1,778.28 Typical High $7,762.47 | Facility | None | $794.33 | $1,778.28 | $7,762.47 |
United Setting Professional Modifier None Typical Low $1,071.52 Median $1,380.38 Typical High $2,691.53 | Professional | None | $1,071.52 | $1,380.38 | $2,691.53 |
Wellpoint Setting Professional Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $1,513.56 | Professional | None | $1,122.02 | $1,122.02 | $1,513.56 |
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 $660.69 Median $724.44 Typical High $851.14 | Professional | 52 · Reduced service | $660.69 | $724.44 | $851.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $288.40 Typical High $338.84 | Professional | 53 · Discontinued | $263.03 | $288.40 | $338.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,000.00 Median $1,071.52 Typical High $1,288.25 | Professional | 54 · Surgery only | $1,000.00 | $1,071.52 | $1,288.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $213.80 Typical High $257.04 | Professional | 55 · Aftercare only | $199.53 | $213.80 | $257.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $131.83 Median $144.54 Typical High $169.82 | Professional | 56 · Pre-op care only | $131.83 | $144.54 | $169.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $1,000.00 Typical High $1,202.26 | Professional | 78 · Unplanned return to OR | $933.25 | $1,000.00 | $1,202.26 |
Where Florida sits
The same service costs 6.3 times more in Alaska than in Texas. 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 $16,928TX $2,675
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.