How much rates vary
Facilitymedian $7,586 · 10th to 90th $1,862 to $44,668Professionalmedian $832 · 10th to 90th $60 to $1,380
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 $6,918.31 Typical High $37,153.52 | Facility | None | $912.01 | $6,918.31 | $37,153.52 |
Aetna Setting Professional Modifier None Typical Low $831.76 Median $912.01 Typical High $1,949.84 | Professional | None | $831.76 | $912.01 | $1,949.84 |
Ambetter Setting Professional Modifier None Typical Low $794.33 Median $794.33 Typical High $1,258.93 | Professional | None | $794.33 | $794.33 | $1,258.93 |
AvMed Setting Facility Modifier None Typical Low $724.44 Median $2,137.96 Typical High $15,848.93 | Facility | None | $724.44 | $2,137.96 | $15,848.93 |
AvMed Setting Professional Modifier None Typical Low $707.95 Median $912.01 Typical High $1,096.48 | Professional | None | $707.95 | $912.01 | $1,096.48 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $27,542.29 Typical High $44,668.36 | Facility | None | $524.81 | $27,542.29 | $44,668.36 |
Cigna Setting Professional Modifier None Typical Low $660.69 Median $954.99 Typical High $1,905.46 | Professional | None | $660.69 | $954.99 | $1,905.46 |
Florida Blue Setting Facility Modifier None Typical Low $2,884.03 Median $5,888.44 Typical High $16,982.44 | Facility | None | $2,884.03 | $5,888.44 | $16,982.44 |
Florida Blue Setting Professional Modifier None Typical Low $588.84 Median $630.96 Typical High $1,023.29 | Professional | None | $588.84 | $630.96 | $1,023.29 |
Molina Setting Professional Modifier None Typical Low $53.70 Median $707.95 Typical High $1,071.52 | Professional | None | $53.70 | $707.95 | $1,071.52 |
United Setting Facility Modifier None Typical Low $4,677.35 Median $32,359.37 Typical High $63,095.73 | Facility | None | $4,677.35 | $32,359.37 | $63,095.73 |
United Setting Professional Modifier None Typical Low $54.95 Median $1,071.52 Typical High $2,398.83 | Professional | None | $54.95 | $1,071.52 | $2,398.83 |
Wellpoint Setting Professional Modifier None Typical Low $616.60 Median $616.60 Typical High $891.25 | Professional | None | $616.60 | $616.60 | $891.25 |
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 $416.87 Median $426.58 Typical High $562.34 | Professional | 52 · Reduced service | $416.87 | $426.58 | $562.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $169.82 Typical High $223.87 | Professional | 53 · Discontinued | $165.96 | $169.82 | $223.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $630.96 Typical High $831.76 | Professional | 54 · Surgery only | $630.96 | $630.96 | $831.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $125.89 Typical High $165.96 | Professional | 55 · Aftercare only | $125.89 | $125.89 | $165.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $85.11 Typical High $112.20 | Professional | 56 · Pre-op care only | $83.18 | $85.11 | $112.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $588.84 Typical High $776.25 | Professional | 78 · Unplanned return to OR | $588.84 | $588.84 | $776.25 |
Ambetter Setting Professional Modifier 22 · Increased work Typical Low $794.33 Median $794.33 Typical High $1,479.11 | Professional | 22 · Increased work | $794.33 | $794.33 | $1,479.11 |
Where Florida sits
The same service costs 19.9 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 $53,750MT $2,699
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.