How much rates vary
Facilitymedian $2,754 · 10th to 90th $437 to $23,988Professionalmedian $1,148 · 10th to 90th $813 to $1,905
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 $1,023.29 Median $5,128.61 Typical High $15,135.61 | Facility | None | $1,023.29 | $5,128.61 | $15,135.61 |
Aetna Setting Professional Modifier None Typical Low $1,047.13 Median $1,071.52 Typical High $1,445.44 | Professional | None | $1,047.13 | $1,071.52 | $1,445.44 |
AvMed Setting Facility Modifier None Typical Low $912.01 Median $2,137.96 Typical High $11,748.98 | Facility | None | $912.01 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $912.01 Median $1,148.15 Typical High $1,380.38 | Professional | None | $912.01 | $1,148.15 | $1,380.38 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $501.19 Typical High $3,235.94 | Facility | None | $398.11 | $501.19 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $851.14 Median $1,230.27 Typical High $2,344.23 | Professional | None | $851.14 | $1,230.27 | $2,344.23 |
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 $794.33 Median $831.76 Typical High $1,318.26 | Professional | None | $794.33 | $831.76 | $1,318.26 |
Molina Setting Professional Modifier None Typical Low $131.83 Median $1,122.02 Typical High $1,548.82 | Professional | None | $131.83 | $1,122.02 | $1,548.82 |
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 $1,047.13 Median $1,548.82 Typical High $3,162.28 | Professional | None | $1,047.13 | $1,548.82 | $3,162.28 |
Wellpoint Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $1,202.26 | Professional | None | $812.83 | $812.83 | $1,202.26 |
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 $524.81 Median $537.03 Typical High $691.83 | Professional | 52 · Reduced service | $524.81 | $537.03 | $691.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $208.93 Median $213.80 Typical High $275.42 | Professional | 53 · Discontinued | $208.93 | $213.80 | $275.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $812.83 Typical High $1,023.29 | Professional | 54 · Surgery only | $776.25 | $812.83 | $1,023.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $162.18 Typical High $204.17 | Professional | 55 · Aftercare only | $154.88 | $162.18 | $204.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $104.71 Median $107.15 Typical High $138.04 | Professional | 56 · Pre-op care only | $104.71 | $107.15 | $138.04 |
Where Florida sits
The same service costs 15.0 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 $27,402MD $1,821
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.