How much rates vary
Facilitymedian $5,370 · 10th to 90th $1,698 to $17,378Professionalmedian $200 · 10th to 90th $126 to $407
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 $758.58 Median $6,025.60 Typical High $12,882.50 | Facility | None | $758.58 | $6,025.60 | $12,882.50 |
Aetna Setting Professional Modifier None Typical Low $102.33 Median $194.98 Typical High $263.03 | Professional | None | $102.33 | $194.98 | $263.03 |
AvMed Setting Facility Modifier None Typical Low $190.55 Median $2,137.96 Typical High $13,803.84 | Facility | None | $190.55 | $2,137.96 | $13,803.84 |
AvMed Setting Professional Modifier None Typical Low $125.89 Median $190.55 Typical High $245.47 | Professional | None | $125.89 | $190.55 | $245.47 |
Florida Blue Setting Facility Modifier None Typical Low $2,884.03 Median $6,165.95 Typical High $19,952.62 | Facility | None | $2,884.03 | $6,165.95 | $19,952.62 |
Florida Blue Setting Professional Modifier None Typical Low $89.13 Median $141.25 Typical High $194.98 | Professional | None | $89.13 | $141.25 | $194.98 |
Molina Setting Professional Modifier None Typical Low $158.49 Median $213.80 Typical High $426.58 | Professional | None | $158.49 | $213.80 | $426.58 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $3,311.31 Typical High $12,589.25 | Facility | None | $1,230.27 | $3,311.31 | $12,589.25 |
United Setting Professional Modifier None Typical Low $60.26 Median $229.09 Typical High $467.74 | Professional | None | $60.26 | $229.09 | $467.74 |
Wellpoint Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $204.17 | Professional | None | $158.49 | $158.49 | $204.17 |
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 $51.29 Median $97.72 Typical High $120.23 | Professional | 52 · Reduced service | $51.29 | $97.72 | $120.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $38.90 Typical High $47.86 | Professional | 53 · Discontinued | $20.42 | $38.90 | $47.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $77.62 Median $147.91 Typical High $177.83 | Professional | 54 · Surgery only | $77.62 | $147.91 | $177.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.49 Median $29.51 Typical High $35.48 | Professional | 55 · Aftercare only | $15.49 | $29.51 | $35.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $19.50 Typical High $23.99 | Professional | 56 · Pre-op care only | $10.23 | $19.50 | $23.99 |
Where Florida sits
The same service costs 88.6 times more in Wyoming 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
WY $59,374MT $670
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.