How much rates vary
Facilitymedian $4,467 · 10th to 90th $1,778 to $14,454Professionalmedian $891 · 10th to 90th $575 to $1,479
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 $812.83 Median $6,025.60 Typical High $13,182.57 | Facility | None | $812.83 | $6,025.60 | $13,182.57 |
Aetna Setting Professional Modifier None Typical Low $851.14 Median $891.25 Typical High $1,698.24 | Professional | None | $851.14 | $891.25 | $1,698.24 |
Ambetter Setting Professional Modifier None Typical Low $2,089.30 Median $2,089.30 Typical High $2,089.30 | Professional | None | $2,089.30 | $2,089.30 | $2,089.30 |
AvMed Setting Facility Modifier None Typical Low $758.58 Median $2,951.21 Typical High $11,748.98 | Facility | None | $758.58 | $2,951.21 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $758.58 Median $1,000.00 Typical High $1,148.15 | Professional | None | $758.58 | $1,000.00 | $1,148.15 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $3,090.30 Typical High $5,623.41 | Facility | None | $501.19 | $3,090.30 | $5,623.41 |
Cigna Setting Professional Modifier None Typical Low $691.83 Median $1,023.29 Typical High $2,041.74 | Professional | None | $691.83 | $1,023.29 | $2,041.74 |
Florida Blue Setting Facility Modifier None Typical Low $2,630.27 Median $5,495.41 Typical High $16,982.44 | Facility | None | $2,630.27 | $5,495.41 | $16,982.44 |
Florida Blue Setting Professional Modifier None Typical Low $630.96 Median $676.08 Typical High $1,000.00 | Professional | None | $630.96 | $676.08 | $1,000.00 |
Molina Setting Professional Modifier None Typical Low $60.26 Median $831.76 Typical High $1,174.90 | Professional | None | $60.26 | $831.76 | $1,174.90 |
United Setting Facility Modifier None Typical Low $1,584.89 Median $4,073.80 Typical High $15,488.17 | Facility | None | $1,584.89 | $4,073.80 | $15,488.17 |
United Setting Professional Modifier None Typical Low $54.95 Median $1,122.02 Typical High $2,511.89 | Professional | None | $54.95 | $1,122.02 | $2,511.89 |
Wellpoint Setting Professional Modifier None Typical Low $660.69 Median $660.69 Typical High $954.99 | Professional | None | $660.69 | $660.69 | $954.99 |
6 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 $426.58 Median $446.68 Typical High $575.44 | Professional | 52 · Reduced service | $426.58 | $446.68 | $575.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $177.83 Typical High $229.09 | Professional | 53 · Discontinued | $169.82 | $177.83 | $229.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $660.69 Typical High $870.96 | Professional | 54 · Surgery only | $645.65 | $660.69 | $870.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $131.83 Typical High $173.78 | Professional | 55 · Aftercare only | $128.82 | $131.83 | $173.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $89.13 Typical High $114.82 | Professional | 56 · Pre-op care only | $85.11 | $89.13 | $114.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $616.60 Typical High $812.83 | Professional | 78 · Unplanned return to OR | $602.56 | $616.60 | $812.83 |
Where Florida sits
The same service costs 4.7 times more in Alaska than in Kentucky. 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 $11,128KY $2,365
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.