How much rates vary
Facilitymedian $912 · 10th to 90th $107 to $6,026Professionalmedian $457 · 10th to 90th $112 to $912
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 $2,884.03 Typical High $10,964.78 | Facility | None | $407.38 | $2,884.03 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $112.20 Median $588.84 Typical High $812.83 | Professional | None | $112.20 | $588.84 | $812.83 |
Ambetter Setting Professional Modifier None Typical Low $125.89 Median $524.81 Typical High $575.44 | Professional | None | $125.89 | $524.81 | $575.44 |
AvMed Setting Facility Modifier None Typical Low $478.63 Median $2,137.96 Typical High $11,748.98 | Facility | None | $478.63 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $141.25 Median $478.63 Typical High $616.60 | Professional | None | $141.25 | $478.63 | $616.60 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $851.14 Typical High $2,691.53 | Facility | None | $446.68 | $851.14 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $109.65 Median $380.19 Typical High $1,000.00 | Professional | None | $109.65 | $380.19 | $1,000.00 |
Florida Blue Setting Facility Modifier None Typical Low $1,348.96 Median $2,754.23 Typical High $6,309.57 | Facility | None | $1,348.96 | $2,754.23 | $6,309.57 |
Florida Blue Setting Professional Modifier None Typical Low $398.11 Median $416.87 Typical High $758.58 | Professional | None | $398.11 | $416.87 | $758.58 |
Molina Setting Professional Modifier None Typical Low $162.18 Median $588.84 Typical High $831.76 | Professional | None | $162.18 | $588.84 | $831.76 |
United Setting Facility Modifier None Typical Low $81.28 Median $302.00 Typical High $2,818.38 | Facility | None | $81.28 | $302.00 | $2,818.38 |
United Setting Professional Modifier None Typical Low $134.90 Median $489.78 Typical High $1,230.27 | Professional | None | $134.90 | $489.78 | $1,230.27 |
Wellpoint Setting Professional Modifier None Typical Low $100.00 Median $446.68 Typical High $446.68 | Professional | None | $100.00 | $446.68 | $446.68 |
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 $56.23 Median $223.87 Typical High $363.08 | Professional | 52 · Reduced service | $56.23 | $223.87 | $363.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $107.15 Typical High $144.54 | Professional | 53 · Discontinued | $22.91 | $107.15 | $144.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $85.11 Median $331.13 Typical High $537.03 | Professional | 54 · Surgery only | $85.11 | $331.13 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $66.07 Typical High $107.15 | Professional | 55 · Aftercare only | $16.98 | $66.07 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $53.70 Typical High $72.44 | Professional | 56 · Pre-op care only | $11.22 | $53.70 | $72.44 |
Where Florida sits
The same service costs 17.4 times more in Alabama than in Montana. 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
AL $9,157MT $526
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.