How much rates vary
Facilitymedian $3,311 · 10th to 90th $1,445 to $13,490Professionalmedian $871 · 10th to 90th $93 to $1,698
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 $912.01 Median $5,754.40 Typical High $12,022.64 | Facility | None | $912.01 | $5,754.40 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $912.01 Median $912.01 Typical High $1,202.26 | Professional | None | $912.01 | $912.01 | $1,202.26 |
Ambetter Setting Professional Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $1,202.26 | Professional | None | $1,202.26 | $1,202.26 | $1,202.26 |
AvMed Setting Facility Modifier None Typical Low $812.83 Median $2,818.38 Typical High $11,748.98 | Facility | None | $812.83 | $2,818.38 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $812.83 Median $1,000.00 Typical High $1,174.90 | Professional | None | $812.83 | $1,000.00 | $1,174.90 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $2,951.21 Typical High $5,370.32 | Facility | None | $501.19 | $2,951.21 | $5,370.32 |
Cigna Setting Professional Modifier None Typical Low $776.25 Median $1,071.52 Typical High $1,995.26 | Professional | None | $776.25 | $1,071.52 | $1,995.26 |
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 $707.95 Median $758.58 Typical High $1,122.02 | Professional | None | $707.95 | $758.58 | $1,122.02 |
Molina Setting Professional Modifier None Typical Low $72.44 Median $758.58 Typical High $1,584.89 | Professional | None | $72.44 | $758.58 | $1,584.89 |
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 $851.14 Median $1,258.93 Typical High $2,290.87 | Professional | None | $851.14 | $1,258.93 | $2,290.87 |
Wellpoint Setting Professional Modifier None Typical Low $776.25 Median $776.25 Typical High $1,000.00 | Professional | None | $776.25 | $776.25 | $1,000.00 |
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 $457.09 Median $457.09 Typical High $602.56 | Professional | 52 · Reduced service | $457.09 | $457.09 | $602.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $181.97 Median $181.97 Typical High $239.88 | Professional | 53 · Discontinued | $181.97 | $181.97 | $239.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $691.83 Typical High $912.01 | Professional | 54 · Surgery only | $676.08 | $691.83 | $912.01 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $138.04 Typical High $181.97 | Professional | 55 · Aftercare only | $134.90 | $138.04 | $181.97 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $91.20 Typical High $120.23 | Professional | 56 · Pre-op care only | $91.20 | $91.20 | $120.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $645.65 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $630.96 | $645.65 | $851.14 |
Where Florida sits
The same service costs 3.4 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 $11,546MT $3,436
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.