How much rates vary
Facilitymedian $1,905 · 10th to 90th $794 to $11,749Professionalmedian $355 · 10th to 90th $46 to $708
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 $549.54 Median $4,073.80 Typical High $11,481.54 | Facility | None | $549.54 | $4,073.80 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $354.81 Median $398.11 Typical High $524.81 | Professional | None | $354.81 | $398.11 | $524.81 |
AvMed Setting Facility Modifier None Typical Low $446.68 Median $1,584.89 Typical High $9,549.93 | Facility | None | $446.68 | $1,584.89 | $9,549.93 |
AvMed Setting Professional Modifier None Typical Low $338.84 Median $416.87 Typical High $501.19 | Professional | None | $338.84 | $416.87 | $501.19 |
Cigna Setting Facility Modifier None Typical Low $436.52 Median $1,698.24 Typical High $2,754.23 | Facility | None | $436.52 | $1,698.24 | $2,754.23 |
Cigna Setting Professional Modifier None Typical Low $302.00 Median $426.58 Typical High $794.33 | Professional | None | $302.00 | $426.58 | $794.33 |
Florida Blue Setting Facility Modifier None Typical Low $977.24 Median $2,089.30 Typical High $16,982.44 | Facility | None | $977.24 | $2,089.30 | $16,982.44 |
Florida Blue Setting Professional Modifier None Typical Low $281.84 Median $302.00 Typical High $467.74 | Professional | None | $281.84 | $302.00 | $467.74 |
Molina Setting Professional Modifier None Typical Low $36.31 Median $323.59 Typical High $676.08 | Professional | None | $36.31 | $323.59 | $676.08 |
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 $60.26 Median $467.74 Typical High $891.25 | Professional | None | $60.26 | $467.74 | $891.25 |
Wellpoint Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $398.11 | Professional | None | $309.03 | $309.03 | $398.11 |
7 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 $177.83 Median $199.53 Typical High $251.19 | Professional | 52 · Reduced service | $177.83 | $199.53 | $251.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $79.43 Typical High $102.33 | Professional | 53 · Discontinued | $70.79 | $79.43 | $102.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $302.00 Typical High $380.19 | Professional | 54 · Surgery only | $263.03 | $302.00 | $380.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $60.26 Typical High $75.86 | Professional | 55 · Aftercare only | $52.48 | $60.26 | $75.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $39.81 Typical High $51.29 | Professional | 56 · Pre-op care only | $35.48 | $39.81 | $51.29 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $245.47 Median $281.84 Typical High $354.81 | Professional | 78 · Unplanned return to OR | $245.47 | $281.84 | $354.81 |
Ambetter Setting Professional Modifier 51 · Multiple procedures Typical Low $691.83 Median $691.83 Typical High $691.83 | Professional | 51 · Multiple procedures | $691.83 | $691.83 | $691.83 |
Where Florida sits
The same service costs 4.1 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 $5,653MT $1,368
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.