How much rates vary
Facilitymedian $5,248 · 10th to 90th $1,778 to $14,454Professionalmedian $851 · 10th to 90th $132 to $1,380
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 $933.25 Median $1,000.00 Typical High $1,348.96 | Professional | None | $933.25 | $1,000.00 | $1,348.96 |
Ambetter Setting Professional Modifier None Typical Low $524.81 Median $1,412.54 Typical High $7,762.47 | Professional | None | $524.81 | $1,412.54 | $7,762.47 |
AvMed Setting Facility Modifier None Typical Low $870.96 Median $4,265.80 Typical High $11,748.98 | Facility | None | $870.96 | $4,265.80 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $870.96 Median $1,122.02 Typical High $1,318.26 | Professional | None | $870.96 | $1,122.02 | $1,318.26 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $5,495.41 Typical High $8,912.51 | Facility | None | $489.78 | $5,495.41 | $8,912.51 |
Cigna Setting Professional Modifier None Typical Low $812.83 Median $870.96 Typical High $1,778.28 | Professional | None | $812.83 | $870.96 | $1,778.28 |
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 $478.63 Median $1,023.29 Typical High $1,318.26 | Professional | None | $478.63 | $1,023.29 | $1,318.26 |
Molina Setting Professional Modifier None Typical Low $91.20 Median $676.08 Typical High $1,230.27 | Professional | None | $91.20 | $676.08 | $1,230.27 |
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 $758.58 Median $977.24 Typical High $1,905.46 | Professional | None | $758.58 | $977.24 | $1,905.46 |
Wellpoint Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $1,071.52 | Professional | None | $812.83 | $812.83 | $1,071.52 |
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 $467.74 Median $501.19 Typical High $602.56 | Professional | 52 · Reduced service | $467.74 | $501.19 | $602.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $186.21 Median $204.17 Typical High $239.88 | Professional | 53 · Discontinued | $186.21 | $204.17 | $239.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $758.58 Typical High $891.25 | Professional | 54 · Surgery only | $691.83 | $758.58 | $891.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $151.36 Typical High $181.97 | Professional | 55 · Aftercare only | $138.04 | $151.36 | $181.97 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $100.00 Typical High $120.23 | Professional | 56 · Pre-op care only | $93.33 | $100.00 | $120.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $707.95 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $645.65 | $707.95 | $831.76 |
Where Florida sits
The same service costs 5.1 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 $14,343KY $2,808
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.