How much rates vary
Facilitymedian $2,512 · 10th to 90th $437 to $23,988Professionalmedian $1,413 · 10th to 90th $145 to $2,399
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 $1,348.96 Median $1,445.44 Typical High $2,570.40 | Professional | None | $1,348.96 | $1,445.44 | $2,570.40 |
Ambetter Setting Professional Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $1,380.38 | Professional | None | $1,380.38 | $1,380.38 | $1,380.38 |
AvMed Setting Facility Modifier None Typical Low $1,202.26 Median $2,137.96 Typical High $11,748.98 | Facility | None | $1,202.26 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $1,202.26 Median $1,513.56 Typical High $1,819.70 | Professional | None | $1,202.26 | $1,513.56 | $1,819.70 |
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 $1,122.02 Median $1,584.89 Typical High $3,162.28 | Professional | None | $1,122.02 | $1,584.89 | $3,162.28 |
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 $1,047.13 Median $1,096.48 Typical High $1,737.80 | Professional | None | $1,047.13 | $1,096.48 | $1,737.80 |
Molina Setting Professional Modifier None Typical Low $125.89 Median $1,318.26 Typical High $1,905.46 | Professional | None | $125.89 | $1,318.26 | $1,905.46 |
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 $1,380.38 Median $2,041.74 Typical High $4,168.69 | Professional | None | $1,380.38 | $2,041.74 | $4,168.69 |
Wellpoint Setting Professional Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $1,584.89 | Professional | None | $1,071.52 | $1,071.52 | $1,584.89 |
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 $691.83 Median $707.95 Typical High $912.01 | Professional | 52 · Reduced service | $691.83 | $707.95 | $912.01 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $275.42 Median $288.40 Typical High $363.08 | Professional | 53 · Discontinued | $275.42 | $288.40 | $363.08 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,047.13 Median $1,071.52 Typical High $1,348.96 | Professional | 54 · Surgery only | $1,047.13 | $1,071.52 | $1,348.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $213.80 Typical High $269.15 | Professional | 55 · Aftercare only | $208.93 | $213.80 | $269.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $138.04 Median $144.54 Typical High $181.97 | Professional | 56 · Pre-op care only | $138.04 | $144.54 | $181.97 |
Where Florida sits
The same service costs 24.1 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 $53,525MD $2,222
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.