How much rates vary
Facilitymedian $2,692 · 10th to 90th $1,072 to $14,454Professionalmedian $646 · 10th to 90th $89 to $1,047
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 $741.31 Median $5,495.41 Typical High $12,302.69 | Facility | None | $741.31 | $5,495.41 | $12,302.69 |
Aetna Setting Professional Modifier None Typical Low $741.31 Median $794.33 Typical High $933.25 | Professional | None | $741.31 | $794.33 | $933.25 |
Ambetter Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $758.58 | Professional | None | $758.58 | $758.58 | $758.58 |
AvMed Setting Facility Modifier None Typical Low $676.08 Median $2,137.96 Typical High $11,748.98 | Facility | None | $676.08 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $645.65 Median $870.96 Typical High $1,023.29 | Professional | None | $645.65 | $870.96 | $1,023.29 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $1,905.46 Typical High $3,235.94 | Facility | None | $512.86 | $1,905.46 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $616.60 Median $660.69 Typical High $1,348.96 | Professional | None | $616.60 | $660.69 | $1,348.96 |
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 $380.19 Median $776.25 Typical High $1,047.13 | Professional | None | $380.19 | $776.25 | $1,047.13 |
Molina Setting Professional Modifier None Typical Low $60.26 Median $489.78 Typical High $891.25 | Professional | None | $60.26 | $489.78 | $891.25 |
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 $588.84 Median $758.58 Typical High $1,479.11 | Professional | None | $588.84 | $758.58 | $1,479.11 |
Wellpoint Setting Professional Modifier None Typical Low $588.84 Median $588.84 Typical High $794.33 | Professional | None | $588.84 | $588.84 | $794.33 |
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 $371.54 Median $398.11 Typical High $467.74 | Professional | 52 · Reduced service | $371.54 | $398.11 | $467.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $158.49 Typical High $186.21 | Professional | 53 · Discontinued | $147.91 | $158.49 | $186.21 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $588.84 Typical High $691.83 | Professional | 54 · Surgery only | $562.34 | $588.84 | $691.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $117.49 Typical High $138.04 | Professional | 55 · Aftercare only | $112.20 | $117.49 | $138.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $79.43 Typical High $93.33 | Professional | 56 · Pre-op care only | $74.13 | $79.43 | $93.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $549.54 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $524.81 | $549.54 | $645.65 |
Where Florida sits
The same service costs 5.0 times more in Alabama 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
AL $11,256KY $2,261
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.