How much rates vary
Facilitymedian $5,888 · 10th to 90th $1,820 to $15,849Professionalmedian $912 · 10th to 90th $138 to $1,622
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 $933.25 Median $6,025.60 Typical High $12,302.69 | Facility | None | $933.25 | $6,025.60 | $12,302.69 |
Aetna Setting Professional Modifier None Typical Low $870.96 Median $933.25 Typical High $1,230.27 | Professional | None | $870.96 | $933.25 | $1,230.27 |
Ambetter Setting Professional Modifier None Typical Low $2,691.53 Median $7,244.36 Typical High $7,244.36 | Professional | None | $2,691.53 | $7,244.36 | $7,244.36 |
AvMed Setting Facility Modifier None Typical Low $1,148.15 Median $4,265.80 Typical High $13,182.57 | Facility | None | $1,148.15 | $4,265.80 | $13,182.57 |
AvMed Setting Professional Modifier None Typical Low $1,071.52 Median $1,202.26 Typical High $1,621.81 | Professional | None | $1,071.52 | $1,202.26 | $1,621.81 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $10,471.29 Typical High $16,982.44 | Facility | None | $489.78 | $10,471.29 | $16,982.44 |
Cigna Setting Professional Modifier None Typical Low $776.25 Median $831.76 Typical High $1,659.59 | Professional | None | $776.25 | $831.76 | $1,659.59 |
Florida Blue Setting Facility Modifier None Typical Low $2,884.03 Median $5,888.44 Typical High $16,982.44 | Facility | None | $2,884.03 | $5,888.44 | $16,982.44 |
Florida Blue Setting Professional Modifier None Typical Low $446.68 Median $1,071.52 Typical High $1,548.82 | Professional | None | $446.68 | $1,071.52 | $1,548.82 |
Molina Setting Professional Modifier None Typical Low $91.20 Median $891.25 Typical High $1,659.59 | Professional | None | $91.20 | $891.25 | $1,659.59 |
United Setting Facility Modifier None Typical Low $1,584.89 Median $4,073.80 Typical High $15,848.93 | Facility | None | $1,584.89 | $4,073.80 | $15,848.93 |
United Setting Professional Modifier None Typical Low $724.44 Median $954.99 Typical High $1,819.70 | Professional | None | $724.44 | $954.99 | $1,819.70 |
Wellpoint Setting Professional Modifier None Typical Low $912.01 Median $912.01 Typical High $1,122.02 | Professional | None | $912.01 | $912.01 | $1,122.02 |
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 $436.52 Median $467.74 Typical High $575.44 | Professional | 52 · Reduced service | $436.52 | $467.74 | $575.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $190.55 Typical High $229.09 | Professional | 53 · Discontinued | $173.78 | $190.55 | $229.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $707.95 Typical High $851.14 | Professional | 54 · Surgery only | $660.69 | $707.95 | $851.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $141.25 Typical High $169.82 | Professional | 55 · Aftercare only | $131.83 | $141.25 | $169.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $93.33 Typical High $114.82 | Professional | 56 · Pre-op care only | $87.10 | $93.33 | $114.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $660.69 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $616.60 | $660.69 | $794.33 |
Where Florida sits
The same service costs 6.0 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 $15,585KY $2,601
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.