How much rates vary
Facilitymedian $2,188 · 10th to 90th $933 to $12,023Professionalmedian $490 · 10th to 90th $79 to $832
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 $588.84 Median $4,073.80 Typical High $11,481.54 | Facility | None | $588.84 | $4,073.80 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $562.34 Median $588.84 Typical High $794.33 | Professional | None | $562.34 | $588.84 | $794.33 |
Ambetter Setting Professional Modifier None Typical Low $281.84 Median $426.58 Typical High $1,148.15 | Professional | None | $281.84 | $426.58 | $1,148.15 |
AvMed Setting Facility Modifier None Typical Low $501.19 Median $1,621.81 Typical High $9,549.93 | Facility | None | $501.19 | $1,621.81 | $9,549.93 |
AvMed Setting Professional Modifier None Typical Low $501.19 Median $676.08 Typical High $776.25 | Professional | None | $501.19 | $676.08 | $776.25 |
Cigna Setting Facility Modifier None Typical Low $436.52 Median $1,862.09 Typical High $2,951.21 | Facility | None | $436.52 | $1,862.09 | $2,951.21 |
Cigna Setting Professional Modifier None Typical Low $467.74 Median $489.78 Typical High $1,023.29 | Professional | None | $467.74 | $489.78 | $1,023.29 |
Florida Blue Setting Facility Modifier None Typical Low $1,230.27 Median $2,630.27 Typical High $16,982.44 | Facility | None | $1,230.27 | $2,630.27 | $16,982.44 |
Florida Blue Setting Professional Modifier None Typical Low $281.84 Median $588.84 Typical High $933.25 | Professional | None | $281.84 | $588.84 | $933.25 |
Molina Setting Professional Modifier None Typical Low $60.26 Median $407.38 Typical High $758.58 | Professional | None | $60.26 | $407.38 | $758.58 |
United Setting Facility Modifier None Typical Low $954.99 Median $2,344.23 Typical High $10,000.00 | Facility | None | $954.99 | $2,344.23 | $10,000.00 |
United Setting Professional Modifier None Typical Low $446.68 Median $575.44 Typical High $1,122.02 | Professional | None | $446.68 | $575.44 | $1,122.02 |
Wellpoint Setting Professional Modifier None Typical Low $478.63 Median $478.63 Typical High $630.96 | Professional | None | $478.63 | $478.63 | $630.96 |
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 $275.42 Median $295.12 Typical High $354.81 | Professional | 52 · Reduced service | $275.42 | $295.12 | $354.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $117.49 Typical High $141.25 | Professional | 53 · Discontinued | $112.20 | $117.49 | $141.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $416.87 Median $446.68 Typical High $537.03 | Professional | 54 · Surgery only | $416.87 | $446.68 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $89.13 Typical High $107.15 | Professional | 55 · Aftercare only | $83.18 | $89.13 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $58.88 Typical High $70.79 | Professional | 56 · Pre-op care only | $56.23 | $58.88 | $70.79 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $389.05 Median $416.87 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $389.05 | $416.87 | $501.19 |
Where Florida sits
The same service costs 3.5 times more in Wisconsin than in Hawaii. 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
WI $7,283HI $2,091
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.