How much rates vary
Facilitymedian $2,692 · 10th to 90th $447 to $26,303Professionalmedian $955 · 10th to 90th $100 to $1,622
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 $3,890.45 Typical High $11,748.98 | Facility | None | $776.25 | $3,890.45 | $11,748.98 |
Aetna Setting Professional Modifier None Typical Low $933.25 Median $1,047.13 Typical High $2,137.96 | Professional | None | $933.25 | $1,047.13 | $2,137.96 |
Ambetter Setting Professional Modifier None Typical Low $891.25 Median $1,023.29 Typical High $1,023.29 | Professional | None | $891.25 | $1,023.29 | $1,023.29 |
AvMed Setting Facility Modifier None Typical Low $812.83 Median $2,137.96 Typical High $13,182.57 | Facility | None | $812.83 | $2,137.96 | $13,182.57 |
AvMed Setting Professional Modifier None Typical Low $812.83 Median $1,023.29 Typical High $1,288.25 | Professional | None | $812.83 | $1,023.29 | $1,288.25 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $549.54 Typical High $19,952.62 | Facility | None | $398.11 | $549.54 | $19,952.62 |
Cigna Setting Professional Modifier None Typical Low $724.44 Median $1,096.48 Typical High $2,238.72 | Professional | None | $724.44 | $1,096.48 | $2,238.72 |
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 $676.08 Median $707.95 Typical High $1,148.15 | Professional | None | $676.08 | $707.95 | $1,148.15 |
Molina Setting Professional Modifier None Typical Low $53.70 Median $851.14 Typical High $1,258.93 | Professional | None | $53.70 | $851.14 | $1,258.93 |
United Setting Facility Modifier None Typical Low $371.54 Median $954.99 Typical High $10,715.19 | Facility | None | $371.54 | $954.99 | $10,715.19 |
United Setting Professional Modifier None Typical Low $870.96 Median $1,318.26 Typical High $2,754.23 | Professional | None | $870.96 | $1,318.26 | $2,754.23 |
Wellpoint Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $1,023.29 | Professional | None | $691.83 | $691.83 | $1,023.29 |
4 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 54 · Surgery only Typical Low $691.83 Median $758.58 Typical High $912.01 | Professional | 54 · Surgery only | $691.83 | $758.58 | $912.01 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $151.36 Typical High $181.97 | Professional | 55 · Aftercare only | $138.04 | $151.36 | $181.97 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $102.33 Typical High $123.03 | Professional | 56 · Pre-op care only | $93.33 | $102.33 | $123.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $707.95 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $645.65 | $707.95 | $851.14 |
Where Florida sits
The same service costs 9.4 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 $15,900MD $1,684
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.