How much rates vary
Facilitymedian $2,399 · 10th to 90th $437 to $24,547Professionalmedian $1,738 · 10th to 90th $158 to $2,818
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 $3,890.45 Typical High $12,022.64 | Facility | None | $776.25 | $3,890.45 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $1,737.80 Median $1,778.28 Typical High $2,290.87 | Professional | None | $1,737.80 | $1,778.28 | $2,290.87 |
AvMed Setting Facility Modifier None Typical Low $1,445.44 Median $2,137.96 Typical High $12,882.50 | Facility | None | $1,445.44 | $2,137.96 | $12,882.50 |
AvMed Setting Professional Modifier None Typical Low $1,513.56 Median $1,905.46 Typical High $2,238.72 | Professional | None | $1,513.56 | $1,905.46 | $2,238.72 |
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 $1,412.54 Median $1,995.26 Typical High $3,890.45 | Professional | None | $1,412.54 | $1,995.26 | $3,890.45 |
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 $1,318.26 Median $1,412.54 Typical High $2,137.96 | Professional | None | $1,318.26 | $1,412.54 | $2,137.96 |
Molina Setting Professional Modifier None Typical Low $144.54 Median $1,479.11 Typical High $2,344.23 | Professional | None | $144.54 | $1,479.11 | $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 $1,737.80 Median $2,570.40 Typical High $5,248.07 | Professional | None | $1,737.80 | $2,570.40 | $5,248.07 |
Wellpoint Setting Professional Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $1,995.26 | Professional | None | $1,380.38 | $1,380.38 | $1,995.26 |
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 $870.96 Median $891.25 Typical High $1,148.15 | Professional | 52 · Reduced service | $870.96 | $891.25 | $1,148.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $346.74 Median $354.81 Typical High $457.09 | Professional | 53 · Discontinued | $346.74 | $354.81 | $457.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,318.26 Median $1,318.26 Typical High $1,698.24 | Professional | 54 · Surgery only | $1,318.26 | $1,318.26 | $1,698.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $263.03 Median $263.03 Typical High $346.74 | Professional | 55 · Aftercare only | $263.03 | $263.03 | $346.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $173.78 Median $177.83 Typical High $229.09 | Professional | 56 · Pre-op care only | $173.78 | $177.83 | $229.09 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,230.27 Median $1,230.27 Typical High $1,584.89 | Professional | 78 · Unplanned return to OR | $1,230.27 | $1,230.27 | $1,584.89 |
Ambetter Setting Professional Modifier 51 · Multiple procedures Typical Low $1,659.59 Median $1,659.59 Typical High $1,659.59 | Professional | 51 · Multiple procedures | $1,659.59 | $1,659.59 | $1,659.59 |
Where Florida sits
The same service costs 8.0 times more in Alabama 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
AL $20,353WA $2,540
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.