How much rates vary
Facilitymedian $2,399 · 10th to 90th $398 to $24,547Professionalmedian $240 · 10th to 90th $166 to $437
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 $645.65 Median $3,890.45 Typical High $12,022.64 | Facility | None | $645.65 | $3,890.45 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $218.78 Median $223.87 Typical High $436.52 | Professional | None | $218.78 | $223.87 | $436.52 |
Ambetter Setting Professional Modifier None Typical Low $309.03 Median $346.74 Typical High $407.38 | Professional | None | $309.03 | $346.74 | $407.38 |
AvMed Setting Facility Modifier None Typical Low $213.80 Median $2,137.96 Typical High $11,748.98 | Facility | None | $213.80 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $186.21 Median $234.42 Typical High $275.42 | Professional | None | $186.21 | $234.42 | $275.42 |
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 $169.82 Median $257.04 Typical High $489.78 | Professional | None | $169.82 | $257.04 | $489.78 |
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 $162.18 Median $169.82 Typical High $269.15 | Professional | None | $162.18 | $169.82 | $269.15 |
Molina Setting Professional Modifier None Typical Low $165.96 Median $229.09 Typical High $316.23 | Professional | None | $165.96 | $229.09 | $316.23 |
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 $213.80 Median $316.23 Typical High $645.65 | Professional | None | $213.80 | $316.23 | $645.65 |
Wellpoint Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $245.47 | Professional | None | $165.96 | $165.96 | $245.47 |
5 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 $109.65 Median $112.20 Typical High $141.25 | Professional | 52 · Reduced service | $109.65 | $112.20 | $141.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $43.65 Median $44.67 Typical High $56.23 | Professional | 53 · Discontinued | $43.65 | $44.67 | $56.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $165.96 Median $165.96 Typical High $208.93 | Professional | 54 · Surgery only | $165.96 | $165.96 | $208.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.11 Median $33.88 Typical High $41.69 | Professional | 55 · Aftercare only | $33.11 | $33.88 | $41.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $22.39 Typical High $28.18 | Professional | 56 · Pre-op care only | $21.88 | $22.39 | $28.18 |
Where Florida sits
The same service costs 7.3 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 $5,199MT $710
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.