How much rates vary
Facilitymedian $4,786 · 10th to 90th $447 to $26,303Professionalmedian $3,802 · 10th to 90th $501 to $7,413
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 $776.25 Median $4,570.88 Typical High $12,022.64 | Facility | None | $776.25 | $4,570.88 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $2,951.21 Median $4,570.88 Typical High $5,623.41 | Professional | None | $2,951.21 | $4,570.88 | $5,623.41 |
AvMed Setting Facility Modifier None Typical Low $1,445.44 Median $4,466.84 Typical High $13,182.57 | Facility | None | $1,445.44 | $4,466.84 | $13,182.57 |
AvMed Setting Professional Modifier None Typical Low $3,630.78 Median $4,786.30 Typical High $5,754.40 | Professional | None | $3,630.78 | $4,786.30 | $5,754.40 |
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 $2,691.53 Median $3,548.13 Typical High $4,570.88 | Professional | None | $2,691.53 | $3,548.13 | $4,570.88 |
Molina Setting Professional Modifier None Typical Low $489.78 Median $3,467.37 Typical High $7,413.10 | Professional | None | $489.78 | $3,467.37 | $7,413.10 |
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 $5,128.61 Typical High $10,471.29 | Professional | None | $60.26 | $5,128.61 | $10,471.29 |
Wellpoint Setting Professional Modifier None Typical Low $3,467.37 Median $3,467.37 Typical High $4,786.30 | Professional | None | $3,467.37 | $3,467.37 | $4,786.30 |
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 $1,479.11 Median $2,290.87 Typical High $2,754.23 | Professional | 52 · Reduced service | $1,479.11 | $2,290.87 | $2,754.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $588.84 Median $912.01 Typical High $1,096.48 | Professional | 53 · Discontinued | $588.84 | $912.01 | $1,096.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,238.72 Median $3,467.37 Typical High $4,168.69 | Professional | 54 · Surgery only | $2,238.72 | $3,467.37 | $4,168.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $446.68 Median $691.83 Typical High $831.76 | Professional | 55 · Aftercare only | $446.68 | $691.83 | $831.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $295.12 Median $457.09 Typical High $549.54 | Professional | 56 · Pre-op care only | $295.12 | $457.09 | $549.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,089.30 Median $3,235.94 Typical High $3,890.45 | Professional | 78 · Unplanned return to OR | $2,089.30 | $3,235.94 | $3,890.45 |
Where Florida sits
The same service costs 8.4 times more in Wisconsin than in Texas. 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 $28,671TX $3,407
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.