How much rates vary
Facilitymedian $2,754 · 10th to 90th $407 to $25,119Professionalmedian $347 · 10th to 90th $240 to $603
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 $407.38 Median $3,090.30 Typical High $11,481.54 | Facility | None | $407.38 | $3,090.30 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $295.12 Median $302.00 Typical High $426.58 | Professional | None | $295.12 | $302.00 | $426.58 |
AvMed Setting Facility Modifier None Typical Low $295.12 Median $2,137.96 Typical High $11,748.98 | Facility | None | $295.12 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $251.19 Median $323.59 Typical High $389.05 | Professional | None | $251.19 | $323.59 | $389.05 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $1,047.13 Typical High $2,691.53 | Facility | None | $457.09 | $1,047.13 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $239.88 Median $338.84 Typical High $660.69 | Professional | None | $239.88 | $338.84 | $660.69 |
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 $218.78 Median $234.42 Typical High $371.54 | Professional | None | $218.78 | $234.42 | $371.54 |
Molina Setting Professional Modifier None Typical Low $269.15 Median $363.08 Typical High $501.19 | Professional | None | $269.15 | $363.08 | $501.19 |
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 $295.12 Median $436.52 Typical High $891.25 | Professional | None | $295.12 | $436.52 | $891.25 |
Wellpoint Setting Professional Modifier None Typical Low $223.87 Median $223.87 Typical High $331.13 | Professional | None | $223.87 | $223.87 | $331.13 |
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 $147.91 Median $151.36 Typical High $190.55 | Professional | 52 · Reduced service | $147.91 | $151.36 | $190.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $58.88 Median $60.26 Typical High $75.86 | Professional | 53 · Discontinued | $58.88 | $60.26 | $75.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $223.87 Median $229.09 Typical High $288.40 | Professional | 54 · Surgery only | $223.87 | $229.09 | $288.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $44.67 Median $45.71 Typical High $57.54 | Professional | 55 · Aftercare only | $44.67 | $45.71 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $29.51 Median $30.20 Typical High $38.02 | Professional | 56 · Pre-op care only | $29.51 | $30.20 | $38.02 |
Where Florida sits
The same service costs 30.0 times more in Maine than in Delaware. 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 $26,760DE $893
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.