How much rates vary
Facilitymedian $2,754 · 10th to 90th $437 to $23,988Professionalmedian $1,288 · 10th to 90th $126 to $2,188
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 $977.24 Median $4,786.30 Typical High $13,182.57 | Facility | None | $977.24 | $4,786.30 | $13,182.57 |
Aetna Setting Professional Modifier None Typical Low $1,230.27 Median $1,288.25 Typical High $1,698.24 | Professional | None | $1,230.27 | $1,288.25 | $1,698.24 |
AvMed Setting Facility Modifier None Typical Low $1,071.52 Median $2,137.96 Typical High $11,748.98 | Facility | None | $1,071.52 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $1,071.52 Median $1,348.96 Typical High $1,621.81 | Professional | None | $1,071.52 | $1,348.96 | $1,621.81 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $501.19 Typical High $10,964.78 | Facility | None | $398.11 | $501.19 | $10,964.78 |
Cigna Setting Professional Modifier None Typical Low $1,000.00 Median $1,445.44 Typical High $2,884.03 | Professional | None | $1,000.00 | $1,445.44 | $2,884.03 |
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 $933.25 Median $1,000.00 Typical High $1,584.89 | Professional | None | $933.25 | $1,000.00 | $1,584.89 |
Molina Setting Professional Modifier None Typical Low $102.33 Median $1,230.27 Typical High $1,698.24 | Professional | None | $102.33 | $1,230.27 | $1,698.24 |
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 $1,230.27 Median $1,862.09 Typical High $3,801.89 | Professional | None | $1,230.27 | $1,862.09 | $3,801.89 |
Wellpoint Setting Professional Modifier None Typical Low $954.99 Median $954.99 Typical High $1,412.54 | Professional | None | $954.99 | $954.99 | $1,412.54 |
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 $630.96 Median $660.69 Typical High $812.83 | Professional | 52 · Reduced service | $630.96 | $660.69 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $251.19 Median $263.03 Typical High $323.59 | Professional | 53 · Discontinued | $251.19 | $263.03 | $323.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $954.99 Median $977.24 Typical High $1,230.27 | Professional | 54 · Surgery only | $954.99 | $977.24 | $1,230.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $190.55 Median $194.98 Typical High $245.47 | Professional | 55 · Aftercare only | $190.55 | $194.98 | $245.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $125.89 Median $131.83 Typical High $162.18 | Professional | 56 · Pre-op care only | $125.89 | $131.83 | $162.18 |
Where Florida sits
The same service costs 25.6 times more in Maine than in Maryland. 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
ME $53,236MD $2,076
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.