How much rates vary
Facilitymedian $3,162 · 10th to 90th $1,349 to $12,882Professionalmedian $617 · 10th to 90th $78 to $1,202
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 $645.65 Median $4,677.35 Typical High $11,748.98 | Facility | None | $645.65 | $4,677.35 | $11,748.98 |
Aetna Setting Professional Modifier None Typical Low $616.60 Median $676.08 Typical High $977.24 | Professional | None | $616.60 | $676.08 | $977.24 |
AvMed Setting Facility Modifier None Typical Low $588.84 Median $2,137.96 Typical High $9,772.37 | Facility | None | $588.84 | $2,137.96 | $9,772.37 |
AvMed Setting Professional Modifier None Typical Low $602.56 Median $758.58 Typical High $870.96 | Professional | None | $602.56 | $758.58 | $870.96 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $2,818.38 Typical High $5,370.32 | Facility | None | $501.19 | $2,818.38 | $5,370.32 |
Cigna Setting Professional Modifier None Typical Low $575.44 Median $776.25 Typical High $1,479.11 | Professional | None | $575.44 | $776.25 | $1,479.11 |
Florida Blue Setting Facility Modifier None Typical Low $1,737.80 Median $3,548.13 Typical High $16,982.44 | Facility | None | $1,737.80 | $3,548.13 | $16,982.44 |
Florida Blue Setting Professional Modifier None Typical Low $512.86 Median $549.54 Typical High $758.58 | Professional | None | $512.86 | $549.54 | $758.58 |
Molina Setting Professional Modifier None Typical Low $72.44 Median $537.03 Typical High $1,148.15 | Professional | None | $72.44 | $537.03 | $1,148.15 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $3,311.31 Typical High $12,589.25 | Facility | None | $1,230.27 | $3,311.31 | $12,589.25 |
United Setting Professional Modifier None Typical Low $60.26 Median $851.14 Typical High $1,584.89 | Professional | None | $60.26 | $851.14 | $1,584.89 |
Wellpoint Setting Professional Modifier None Typical Low $562.34 Median $562.34 Typical High $724.44 | Professional | None | $562.34 | $562.34 | $724.44 |
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 $309.03 Median $338.84 Typical High $446.68 | Professional | 52 · Reduced service | $309.03 | $338.84 | $446.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $134.90 Typical High $177.83 | Professional | 53 · Discontinued | $125.89 | $134.90 | $177.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $501.19 Typical High $660.69 | Professional | 54 · Surgery only | $467.74 | $501.19 | $660.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $100.00 Typical High $131.83 | Professional | 55 · Aftercare only | $93.33 | $100.00 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $67.61 Typical High $89.13 | Professional | 56 · Pre-op care only | $61.66 | $67.61 | $89.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $467.74 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $436.52 | $467.74 | $616.60 |
Where Florida sits
The same service costs 4.2 times more in Alaska 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
AK $10,315MT $2,461
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.