How much rates vary
Facilitymedian $2,138 · 10th to 90th $794 to $7,413Professionalmedian $417 · 10th to 90th $316 to $794
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 $616.60 Median $4,897.79 Typical High $11,481.54 | Facility | None | $616.60 | $4,897.79 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $398.11 Median $407.38 Typical High $537.03 | Professional | None | $398.11 | $407.38 | $537.03 |
AvMed Setting Facility Modifier None Typical Low $389.05 Median $2,137.96 Typical High $11,748.98 | Facility | None | $389.05 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $309.03 Median $389.05 Typical High $489.78 | Professional | None | $309.03 | $389.05 | $489.78 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $1,000.00 Typical High $2,691.53 | Facility | None | $478.63 | $1,000.00 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $316.23 Median $436.52 Typical High $831.76 | Professional | None | $316.23 | $436.52 | $831.76 |
Florida Blue Setting Facility Modifier None Typical Low $1,230.27 Median $2,570.40 Typical High $6,309.57 | Facility | None | $1,230.27 | $2,570.40 | $6,309.57 |
Florida Blue Setting Professional Modifier None Typical Low $269.15 Median $288.40 Typical High $489.78 | Professional | None | $269.15 | $288.40 | $489.78 |
Molina Setting Professional Modifier None Typical Low $338.84 Median $446.68 Typical High $794.33 | Professional | None | $338.84 | $446.68 | $794.33 |
United Setting Facility Modifier None Typical Low $794.33 Median $1,778.28 Typical High $7,585.78 | Facility | None | $794.33 | $1,778.28 | $7,585.78 |
United Setting Professional Modifier None Typical Low $363.08 Median $537.03 Typical High $977.24 | Professional | None | $363.08 | $537.03 | $977.24 |
Wellpoint Setting Professional Modifier None Typical Low $302.00 Median $302.00 Typical High $389.05 | Professional | None | $302.00 | $302.00 | $389.05 |
5 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 $199.53 Median $204.17 Typical High $251.19 | Professional | 52 · Reduced service | $199.53 | $204.17 | $251.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $81.28 Typical High $100.00 | Professional | 53 · Discontinued | $79.43 | $81.28 | $100.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $295.12 Median $302.00 Typical High $380.19 | Professional | 54 · Surgery only | $295.12 | $302.00 | $380.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $60.26 Typical High $75.86 | Professional | 55 · Aftercare only | $58.88 | $60.26 | $75.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $40.74 Typical High $50.12 | Professional | 56 · Pre-op care only | $39.81 | $40.74 | $50.12 |
Where Florida sits
The same service costs 5.5 times more in Oklahoma 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
OK $7,298MT $1,321
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.