How much rates vary
Facilitymedian $3,162 · 10th to 90th $1,230 to $12,882Professionalmedian $1,230 · 10th to 90th $112 to $1,995
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 $4,897.79 Typical High $12,022.64 | Facility | None | $776.25 | $4,897.79 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $1,148.15 Median $1,258.93 Typical High $2,089.30 | Professional | None | $1,148.15 | $1,258.93 | $2,089.30 |
Ambetter Setting Professional Modifier None Typical Low $1,584.89 Median $1,584.89 Typical High $1,584.89 | Professional | None | $1,584.89 | $1,584.89 | $1,584.89 |
AvMed Setting Facility Modifier None Typical Low $1,023.29 Median $2,951.21 Typical High $11,748.98 | Facility | None | $1,023.29 | $2,951.21 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $1,096.48 Median $1,348.96 Typical High $1,584.89 | Professional | None | $1,096.48 | $1,348.96 | $1,584.89 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $3,090.30 Typical High $5,623.41 | Facility | None | $489.78 | $3,090.30 | $5,623.41 |
Cigna Setting Professional Modifier None Typical Low $977.24 Median $1,412.54 Typical High $2,630.27 | Professional | None | $977.24 | $1,412.54 | $2,630.27 |
Florida Blue Setting Facility Modifier None Typical Low $1,737.80 Median $3,548.13 Typical High $16,982.44 | Facility | None | $1,737.80 | $3,548.13 | $16,982.44 |
Florida Blue Setting Professional Modifier None Typical Low $891.25 Median $954.99 Typical High $1,348.96 | Professional | None | $891.25 | $954.99 | $1,348.96 |
Molina Setting Professional Modifier None Typical Low $104.71 Median $1,148.15 Typical High $1,621.81 | Professional | None | $104.71 | $1,148.15 | $1,621.81 |
United Setting Facility Modifier None Typical Low $954.99 Median $2,344.23 Typical High $10,000.00 | Facility | None | $954.99 | $2,344.23 | $10,000.00 |
United Setting Professional Modifier None Typical Low $54.95 Median $1,548.82 Typical High $3,467.37 | Professional | None | $54.95 | $1,548.82 | $3,467.37 |
Wellpoint Setting Professional Modifier None Typical Low $933.25 Median $933.25 Typical High $1,348.96 | Professional | None | $933.25 | $933.25 | $1,348.96 |
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 $575.44 Median $616.60 Typical High $794.33 | Professional | 52 · Reduced service | $575.44 | $616.60 | $794.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $251.19 Typical High $316.23 | Professional | 53 · Discontinued | $234.42 | $251.19 | $316.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $933.25 Typical High $1,202.26 | Professional | 54 · Surgery only | $870.96 | $933.25 | $1,202.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $186.21 Typical High $239.88 | Professional | 55 · Aftercare only | $173.78 | $186.21 | $239.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $125.89 Typical High $158.49 | Professional | 56 · Pre-op care only | $114.82 | $125.89 | $158.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $870.96 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $812.83 | $870.96 | $1,122.02 |
Where Florida sits
The same service costs 6.6 times more in Alabama 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
AL $18,462KY $2,797
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.