How much rates vary
Facilitymedian $7,244 · 10th to 90th $1,862 to $22,387Professionalmedian $4,365 · 10th to 90th $437 to $8,511
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 $776.25 Median $5,623.41 Typical High $15,135.61 | Facility | None | $776.25 | $5,623.41 | $15,135.61 |
Aetna Setting Professional Modifier None Typical Low $457.09 Median $5,370.32 Typical High $7,244.36 | Professional | None | $457.09 | $5,370.32 | $7,244.36 |
Ambetter Setting Professional Modifier None Typical Low $436.52 Median $436.52 Typical High $489.78 | Professional | None | $436.52 | $436.52 | $489.78 |
AvMed Setting Facility Modifier None Typical Low $891.25 Median $2,570.40 Typical High $11,748.98 | Facility | None | $891.25 | $2,570.40 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $489.78 Median $4,786.30 Typical High $6,165.95 | Professional | None | $489.78 | $4,786.30 | $6,165.95 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $13,803.84 Typical High $22,387.21 | Facility | None | $501.19 | $13,803.84 | $22,387.21 |
Cigna Setting Professional Modifier None Typical Low $380.19 Median $1,258.93 Typical High $9,120.11 | Professional | None | $380.19 | $1,258.93 | $9,120.11 |
Florida Blue Setting Facility Modifier None Typical Low $2,884.03 Median $5,888.44 Typical High $16,982.44 | Facility | None | $2,884.03 | $5,888.44 | $16,982.44 |
Florida Blue Setting Professional Modifier None Typical Low $3,981.07 Median $4,265.80 Typical High $6,918.31 | Professional | None | $3,981.07 | $4,265.80 | $6,918.31 |
Molina Setting Professional Modifier None Typical Low $912.01 Median $6,165.95 Typical High $8,511.38 | Professional | None | $912.01 | $6,165.95 | $8,511.38 |
United Setting Facility Modifier None Typical Low $3,630.78 Median $15,848.93 Typical High $34,673.69 | Facility | None | $3,630.78 | $15,848.93 | $34,673.69 |
United Setting Professional Modifier None Typical Low $489.78 Median $4,265.80 Typical High $11,481.54 | Professional | None | $489.78 | $4,265.80 | $11,481.54 |
Wellpoint Setting Professional Modifier None Typical Low $346.74 Median $4,265.80 Typical High $4,265.80 | Professional | None | $346.74 | $4,265.80 | $4,265.80 |
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 $229.09 Median $776.25 Typical High $3,311.31 | Professional | 52 · Reduced service | $229.09 | $776.25 | $3,311.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $309.03 Typical High $1,318.26 | Professional | 53 · Discontinued | $91.20 | $309.03 | $1,318.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $338.84 Median $1,174.90 Typical High $5,011.87 | Professional | 54 · Surgery only | $338.84 | $1,174.90 | $5,011.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $234.42 Typical High $1,000.00 | Professional | 55 · Aftercare only | $67.61 | $234.42 | $1,000.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $154.88 Typical High $660.69 | Professional | 56 · Pre-op care only | $45.71 | $154.88 | $660.69 |
Where Florida sits
The same service costs 6.1 times more in Alaska than in Vermont. 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 $33,081VT $5,424
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.