How much rates vary
Facilitymedian $162 · 10th to 90th $66 to $3,548Professionalmedian $95 · 10th to 90th $69 to $158
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 $107.15 Median $2,884.03 Typical High $10,964.78 | Facility | None | $107.15 | $2,884.03 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $69.18 Median $85.11 Typical High $120.23 | Professional | None | $69.18 | $85.11 | $120.23 |
Ambetter Setting Professional Modifier None Typical Low $114.82 Median $114.82 Typical High $114.82 | Professional | None | $114.82 | $114.82 | $114.82 |
AvMed Setting Facility Modifier None Typical Low $114.82 Median $2,137.96 Typical High $11,748.98 | Facility | None | $114.82 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $87.10 Median $114.82 Typical High $158.49 | Professional | None | $87.10 | $114.82 | $158.49 |
Cigna Setting Facility Modifier None Typical Low $52.48 Median $109.65 Typical High $213.80 | Facility | None | $52.48 | $109.65 | $213.80 |
Cigna Setting Professional Modifier None Typical Low $67.61 Median $91.20 Typical High $154.88 | Professional | None | $67.61 | $91.20 | $154.88 |
Florida Blue Setting Facility Modifier None Typical Low $61.66 Median $131.83 Typical High $3,019.95 | Facility | None | $61.66 | $131.83 | $3,019.95 |
Florida Blue Setting Professional Modifier None Typical Low $43.65 Median $109.65 Typical High $162.18 | Professional | None | $43.65 | $109.65 | $162.18 |
Molina Setting Professional Modifier None Typical Low $77.62 Median $109.65 Typical High $190.55 | Professional | None | $77.62 | $109.65 | $190.55 |
United Setting Facility Modifier None Typical Low $81.28 Median $302.00 Typical High $2,818.38 | Facility | None | $81.28 | $302.00 | $2,818.38 |
United Setting Professional Modifier None Typical Low $63.10 Median $87.10 Typical High $177.83 | Professional | None | $63.10 | $87.10 | $177.83 |
Wellpoint Setting Professional Modifier None Typical Low $100.00 Median $147.91 Typical High $147.91 | Professional | None | $100.00 | $147.91 | $147.91 |
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 $34.67 Median $42.66 Typical High $58.88 | Professional | 52 · Reduced service | $34.67 | $42.66 | $58.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $16.98 Typical High $23.44 | Professional | 53 · Discontinued | $13.80 | $16.98 | $23.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $52.48 Median $63.10 Typical High $89.13 | Professional | 54 · Surgery only | $52.48 | $63.10 | $89.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.47 Median $12.88 Typical High $17.78 | Professional | 55 · Aftercare only | $10.47 | $12.88 | $17.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $8.51 Typical High $11.75 | Professional | 56 · Pre-op care only | $6.92 | $8.51 | $11.75 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $48.98 Median $58.88 Typical High $83.18 | Professional | 78 · Unplanned return to OR | $48.98 | $58.88 | $83.18 |
Where Florida sits
The same service costs 13.1 times more in Hawaii than in Maryland. 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
HI $2,944MD $224
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.