How much rates vary
Facilitymedian $5,129 · 10th to 90th $1,660 to $15,136Professionalmedian $1,023 · 10th to 90th $178 to $1,660
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 $1,096.48 Median $5,888.44 Typical High $12,302.69 | Facility | None | $1,096.48 | $5,888.44 | $12,302.69 |
Aetna Setting Professional Modifier None Typical Low $1,071.52 Median $1,174.90 Typical High $1,548.82 | Professional | None | $1,071.52 | $1,174.90 | $1,548.82 |
Ambetter Setting Professional Modifier None Typical Low $1,258.93 Median $1,905.46 Typical High $2,511.89 | Professional | None | $1,258.93 | $1,905.46 | $2,511.89 |
AvMed Setting Facility Modifier None Typical Low $691.83 Median $2,137.96 Typical High $11,748.98 | Facility | None | $691.83 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $1,023.29 Median $1,348.96 Typical High $1,513.56 | Professional | None | $1,023.29 | $1,348.96 | $1,513.56 |
Cigna Setting Facility Modifier None Typical Low $616.60 Median $8,709.64 Typical High $16,218.10 | Facility | None | $616.60 | $8,709.64 | $16,218.10 |
Cigna Setting Professional Modifier None Typical Low $954.99 Median $1,023.29 Typical High $2,041.74 | Professional | None | $954.99 | $1,023.29 | $2,041.74 |
Florida Blue Setting Facility Modifier None Typical Low $2,884.03 Median $5,623.41 Typical High $16,982.44 | Facility | None | $2,884.03 | $5,623.41 | $16,982.44 |
Florida Blue Setting Professional Modifier None Typical Low $537.03 Median $1,148.15 Typical High $1,380.38 | Professional | None | $537.03 | $1,148.15 | $1,380.38 |
Molina Setting Professional Modifier None Typical Low $120.23 Median $831.76 Typical High $1,479.11 | Professional | None | $120.23 | $831.76 | $1,479.11 |
United Setting Facility Modifier None Typical Low $1,621.81 Median $4,570.88 Typical High $15,848.93 | Facility | None | $1,621.81 | $4,570.88 | $15,848.93 |
United Setting Professional Modifier None Typical Low $870.96 Median $1,148.15 Typical High $2,187.76 | Professional | None | $870.96 | $1,148.15 | $2,187.76 |
Wellpoint Setting Professional Modifier None Typical Low $954.99 Median $954.99 Typical High $1,258.93 | Professional | None | $954.99 | $954.99 | $1,258.93 |
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 $537.03 Median $588.84 Typical High $691.83 | Professional | 52 · Reduced service | $537.03 | $588.84 | $691.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $213.80 Median $234.42 Typical High $281.84 | Professional | 53 · Discontinued | $213.80 | $234.42 | $281.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $794.33 Median $870.96 Typical High $1,047.13 | Professional | 54 · Surgery only | $794.33 | $870.96 | $1,047.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $177.83 Typical High $208.93 | Professional | 55 · Aftercare only | $158.49 | $177.83 | $208.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $117.49 Typical High $141.25 | Professional | 56 · Pre-op care only | $107.15 | $117.49 | $141.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $741.31 Median $812.83 Typical High $977.24 | Professional | 78 · Unplanned return to OR | $741.31 | $812.83 | $977.24 |
Where Florida sits
The same service costs 6.5 times more in Alaska 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
AK $22,748HI $3,479
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.