How much rates vary
Facilitymedian $2,042 · 10th to 90th $759 to $11,749Professionalmedian $380 · 10th to 90th $72 to $617
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 $549.54 Median $4,073.80 Typical High $11,481.54 | Facility | None | $549.54 | $4,073.80 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $398.11 Median $416.87 Typical High $562.34 | Professional | None | $398.11 | $416.87 | $562.34 |
Ambetter Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $213.80 | Professional | None | $213.80 | $213.80 | $213.80 |
AvMed Setting Facility Modifier None Typical Low $446.68 Median $1,995.26 Typical High $9,772.37 | Facility | None | $446.68 | $1,995.26 | $9,772.37 |
AvMed Setting Professional Modifier None Typical Low $363.08 Median $478.63 Typical High $549.54 | Professional | None | $363.08 | $478.63 | $549.54 |
Cigna Setting Facility Modifier None Typical Low $436.52 Median $3,467.37 Typical High $6,606.93 | Facility | None | $436.52 | $3,467.37 | $6,606.93 |
Cigna Setting Professional Modifier None Typical Low $338.84 Median $354.81 Typical High $741.31 | Professional | None | $338.84 | $354.81 | $741.31 |
Florida Blue Setting Facility Modifier None Typical Low $891.25 Median $1,905.46 Typical High $16,982.44 | Facility | None | $891.25 | $1,905.46 | $16,982.44 |
Florida Blue Setting Professional Modifier None Typical Low $199.53 Median $436.52 Typical High $851.14 | Professional | None | $199.53 | $436.52 | $851.14 |
Molina Setting Professional Modifier None Typical Low $54.95 Median $323.59 Typical High $562.34 | Professional | None | $54.95 | $323.59 | $562.34 |
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 $309.03 Median $416.87 Typical High $794.33 | Professional | None | $309.03 | $416.87 | $794.33 |
Wellpoint Setting Professional Modifier None Typical Low $346.74 Median $346.74 Typical High $457.09 | Professional | None | $346.74 | $346.74 | $457.09 |
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 $199.53 Median $208.93 Typical High $257.04 | Professional | 52 · Reduced service | $199.53 | $208.93 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $83.18 Typical High $104.71 | Professional | 53 · Discontinued | $79.43 | $83.18 | $104.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $295.12 Median $316.23 Typical High $389.05 | Professional | 54 · Surgery only | $295.12 | $316.23 | $389.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $63.10 Typical High $77.62 | Professional | 55 · Aftercare only | $58.88 | $63.10 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $41.69 Typical High $51.29 | Professional | 56 · Pre-op care only | $39.81 | $41.69 | $51.29 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $275.42 Median $295.12 Typical High $363.08 | Professional | 78 · Unplanned return to OR | $275.42 | $295.12 | $363.08 |
Where Florida sits
The same service costs 7.0 times more in Alabama than in Montana. 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
AL $10,808MT $1,535
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.