How much rates vary
Facilitymedian $4,786 · 10th to 90th $1,549 to $13,490Professionalmedian $1,259 · 10th to 90th $195 to $1,995
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 $12,882.50 | Facility | None | $851.14 | $6,025.60 | $12,882.50 |
Aetna Setting Professional Modifier None Typical Low $1,380.38 Median $1,513.56 Typical High $1,862.09 | Professional | None | $1,380.38 | $1,513.56 | $1,862.09 |
Ambetter Setting Professional Modifier None Typical Low $251.19 Median $1,862.09 Typical High $1,862.09 | Professional | None | $251.19 | $1,862.09 | $1,862.09 |
AvMed Setting Facility Modifier None Typical Low $1,258.93 Median $4,265.80 Typical High $11,748.98 | Facility | None | $1,258.93 | $4,265.80 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $1,258.93 Median $1,659.59 Typical High $1,905.46 | Professional | None | $1,258.93 | $1,659.59 | $1,905.46 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $4,570.88 Typical High $8,709.64 | Facility | None | $512.86 | $4,570.88 | $8,709.64 |
Cigna Setting Professional Modifier None Typical Low $1,202.26 Median $1,258.93 Typical High $2,570.40 | Professional | None | $1,202.26 | $1,258.93 | $2,570.40 |
Florida Blue Setting Facility Modifier None Typical Low $2,818.38 Median $5,495.41 Typical High $16,982.44 | Facility | None | $2,818.38 | $5,495.41 | $16,982.44 |
Florida Blue Setting Professional Modifier None Typical Low $707.95 Median $1,479.11 Typical High $1,819.70 | Professional | None | $707.95 | $1,479.11 | $1,819.70 |
Molina Setting Professional Modifier None Typical Low $147.91 Median $1,000.00 Typical High $1,819.70 | Professional | None | $147.91 | $1,000.00 | $1,819.70 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $3,311.31 Typical High $12,589.25 | Facility | None | $1,230.27 | $3,311.31 | $12,589.25 |
United Setting Professional Modifier None Typical Low $1,122.02 Median $1,445.44 Typical High $2,818.38 | Professional | None | $1,122.02 | $1,445.44 | $2,818.38 |
Wellpoint Setting Professional Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $1,548.82 | Professional | None | $1,148.15 | $1,148.15 | $1,548.82 |
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 $691.83 Median $741.31 Typical High $891.25 | Professional | 52 · Reduced service | $691.83 | $741.31 | $891.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $275.42 Median $302.00 Typical High $354.81 | Professional | 53 · Discontinued | $275.42 | $302.00 | $354.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,047.13 Median $1,122.02 Typical High $1,348.96 | Professional | 54 · Surgery only | $1,047.13 | $1,122.02 | $1,348.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $223.87 Typical High $269.15 | Professional | 55 · Aftercare only | $208.93 | $223.87 | $269.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $138.04 Median $151.36 Typical High $177.83 | Professional | 56 · Pre-op care only | $138.04 | $151.36 | $177.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $977.24 Median $1,047.13 Typical High $1,258.93 | Professional | 78 · Unplanned return to OR | $977.24 | $1,047.13 | $1,258.93 |
Where Florida sits
The same service costs 4.7 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 $16,761KY $3,604
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.