How much rates vary
Facilitymedian $2,512 · 10th to 90th $437 to $24,547Professionalmedian $1,202 · 10th to 90th $120 to $2,344
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 $1,230.27 Median $1,258.93 Typical High $1,862.09 | Professional | None | $1,230.27 | $1,258.93 | $1,862.09 |
Ambetter Setting Professional Modifier None Typical Low $245.47 Median $1,548.82 Typical High $1,819.70 | Professional | None | $245.47 | $1,548.82 | $1,819.70 |
AvMed Setting Facility Modifier None Typical Low $1,071.52 Median $2,137.96 Typical High $13,182.57 | Facility | None | $1,071.52 | $2,137.96 | $13,182.57 |
AvMed Setting Professional Modifier None Typical Low $1,071.52 Median $1,412.54 Typical High $1,659.59 | Professional | None | $1,071.52 | $1,412.54 | $1,659.59 |
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 $977.24 Median $1,380.38 Typical High $2,818.38 | Professional | None | $977.24 | $1,380.38 | $2,818.38 |
Florida Blue Setting Facility Modifier None Typical Low $10,000.00 Median $21,877.62 Typical High $33,884.42 | Facility | None | $10,000.00 | $21,877.62 | $33,884.42 |
Florida Blue Setting Professional Modifier None Typical Low $954.99 Median $1,023.29 Typical High $1,548.82 | Professional | None | $954.99 | $1,023.29 | $1,548.82 |
Molina Setting Professional Modifier None Typical Low $107.15 Median $1,071.52 Typical High $2,238.72 | Professional | None | $107.15 | $1,071.52 | $2,238.72 |
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 $1,148.15 Median $1,698.24 Typical High $3,090.30 | Professional | None | $1,148.15 | $1,698.24 | $3,090.30 |
Wellpoint Setting Professional Modifier None Typical Low $977.24 Median $977.24 Typical High $1,348.96 | Professional | None | $977.24 | $977.24 | $1,348.96 |
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 $616.60 Median $630.96 Typical High $776.25 | Professional | 52 · Reduced service | $616.60 | $630.96 | $776.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $245.47 Median $251.19 Typical High $309.03 | Professional | 53 · Discontinued | $245.47 | $251.19 | $309.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $933.25 Typical High $1,148.15 | Professional | 54 · Surgery only | $933.25 | $933.25 | $1,148.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $190.55 Typical High $229.09 | Professional | 55 · Aftercare only | $186.21 | $190.55 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $125.89 Typical High $154.88 | Professional | 56 · Pre-op care only | $123.03 | $125.89 | $154.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $870.96 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $870.96 | $870.96 | $1,071.52 |
Where Florida sits
The same service costs 6.0 times more in Wisconsin 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
WI $12,017WA $2,002
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.