How much rates vary
Facilitymedian $2,399 · 10th to 90th $437 to $24,547Professionalmedian $1,778 · 10th to 90th $155 to $2,884
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 $1,778.28 Median $1,819.70 Typical High $3,467.37 | Professional | None | $1,778.28 | $1,819.70 | $3,467.37 |
Ambetter Setting Professional Modifier None Typical Low $891.25 Median $891.25 Typical High $891.25 | Professional | None | $891.25 | $891.25 | $891.25 |
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 $1,621.81 Median $2,041.74 Typical High $2,344.23 | Professional | None | $1,621.81 | $2,041.74 | $2,344.23 |
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 $2,137.96 Typical High $4,168.69 | Professional | None | $1,412.54 | $2,137.96 | $4,168.69 |
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 $1,348.96 Median $1,445.44 Typical High $2,041.74 | Professional | None | $1,348.96 | $1,445.44 | $2,041.74 |
Molina Setting Professional Modifier None Typical Low $144.54 Median $1,513.56 Typical High $2,398.83 | Professional | None | $144.54 | $1,513.56 | $2,398.83 |
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 $54.95 Median $2,290.87 Typical High $5,011.87 | Professional | None | $54.95 | $2,290.87 | $5,011.87 |
Wellpoint Setting Professional Modifier None Typical Low $1,412.54 Median $1,412.54 Typical High $2,041.74 | Professional | None | $1,412.54 | $1,412.54 | $2,041.74 |
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 $891.25 Median $891.25 Typical High $1,174.90 | Professional | 52 · Reduced service | $891.25 | $891.25 | $1,174.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $354.81 Median $363.08 Typical High $467.74 | Professional | 53 · Discontinued | $354.81 | $363.08 | $467.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,318.26 Median $1,348.96 Typical High $1,778.28 | Professional | 54 · Surgery only | $1,318.26 | $1,348.96 | $1,778.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $269.15 Median $269.15 Typical High $354.81 | Professional | 55 · Aftercare only | $269.15 | $269.15 | $354.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $177.83 Median $181.97 Typical High $234.42 | Professional | 56 · Pre-op care only | $177.83 | $181.97 | $234.42 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,230.27 Median $1,258.93 Typical High $1,659.59 | Professional | 78 · Unplanned return to OR | $1,230.27 | $1,258.93 | $1,659.59 |
Where Florida sits
The same service costs 12.9 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 $34,193WA $2,645
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.