How much rates vary
Facilitymedian $2,512 · 10th to 90th $437 to $25,119Professionalmedian $1,259 · 10th to 90th $117 to $2,455
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 $1,000.00 Median $4,897.79 Typical High $12,022.64 | Facility | None | $1,000.00 | $4,897.79 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $1,258.93 Median $1,318.26 Typical High $2,570.40 | Professional | None | $1,258.93 | $1,318.26 | $2,570.40 |
Ambetter Setting Professional Modifier None Typical Low $173.78 Median $1,288.25 Typical High $1,621.81 | Professional | None | $173.78 | $1,288.25 | $1,621.81 |
AvMed Setting Facility Modifier None Typical Low $1,122.02 Median $2,137.96 Typical High $13,182.57 | Facility | None | $1,122.02 | $2,137.96 | $13,182.57 |
AvMed Setting Professional Modifier None Typical Low $1,174.90 Median $1,479.11 Typical High $1,698.24 | Professional | None | $1,174.90 | $1,479.11 | $1,698.24 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $501.19 Typical High $2,691.53 | Facility | None | $398.11 | $501.19 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $1,023.29 Median $1,412.54 Typical High $2,951.21 | Professional | None | $1,023.29 | $1,412.54 | $2,951.21 |
Florida Blue Setting Facility Modifier None Typical Low $10,471.29 Median $22,387.21 Typical High $33,884.42 | Facility | None | $10,471.29 | $22,387.21 | $33,884.42 |
Florida Blue Setting Professional Modifier None Typical Low $977.24 Median $1,047.13 Typical High $1,548.82 | Professional | None | $977.24 | $1,047.13 | $1,548.82 |
Molina Setting Professional Modifier None Typical Low $107.15 Median $1,122.02 Typical High $2,344.23 | Professional | None | $107.15 | $1,122.02 | $2,344.23 |
United Setting Facility Modifier None Typical Low $371.54 Median $954.99 Typical High $7,585.78 | Facility | None | $371.54 | $954.99 | $7,585.78 |
United Setting Professional Modifier None Typical Low $60.26 Median $1,548.82 Typical High $3,019.95 | Professional | None | $60.26 | $1,548.82 | $3,019.95 |
Wellpoint Setting Professional Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $1,412.54 | Professional | None | $1,023.29 | $1,023.29 | $1,412.54 |
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 $630.96 Median $660.69 Typical High $812.83 | Professional | 52 · Reduced service | $630.96 | $660.69 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $251.19 Median $263.03 Typical High $323.59 | Professional | 53 · Discontinued | $251.19 | $263.03 | $323.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $977.24 Typical High $1,230.27 | Professional | 54 · Surgery only | $933.25 | $977.24 | $1,230.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $194.98 Typical High $245.47 | Professional | 55 · Aftercare only | $186.21 | $194.98 | $245.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $125.89 Median $131.83 Typical High $162.18 | Professional | 56 · Pre-op care only | $125.89 | $131.83 | $162.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $912.01 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $870.96 | $912.01 | $1,148.15 |
Where Florida sits
The same service costs 13.5 times more in Maine than in Washington. 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
ME $28,253WA $2,096
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.