How much rates vary
Facilitymedian $2,630 · 10th to 90th $457 to $20,417Professionalmedian $263 · 10th to 90th $191 to $501
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 $645.65 Median $3,890.45 Typical High $12,022.64 | Facility | None | $645.65 | $3,890.45 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $229.09 Median $251.19 Typical High $489.78 | Professional | None | $229.09 | $251.19 | $489.78 |
AvMed Setting Facility Modifier None Typical Low $239.88 Median $2,137.96 Typical High $11,748.98 | Facility | None | $239.88 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $218.78 Median $269.15 Typical High $331.13 | Professional | None | $218.78 | $269.15 | $331.13 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $501.19 Typical High $2,691.53 | Facility | None | $398.11 | $501.19 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $194.98 Median $275.42 Typical High $524.81 | Professional | None | $194.98 | $275.42 | $524.81 |
Florida Blue Setting Facility Modifier None Typical Low $1,778.28 Median $3,630.78 Typical High $25,703.96 | Facility | None | $1,778.28 | $3,630.78 | $25,703.96 |
Florida Blue Setting Professional Modifier None Typical Low $181.97 Median $194.98 Typical High $295.12 | Professional | None | $181.97 | $194.98 | $295.12 |
Molina Setting Professional Modifier None Typical Low $194.98 Median $269.15 Typical High $512.86 | Professional | None | $194.98 | $269.15 | $512.86 |
United Setting Facility Modifier None Typical Low $371.54 Median $954.99 Typical High $7,585.78 | Facility | None | $371.54 | $954.99 | $7,585.78 |
United Setting Professional Modifier None Typical Low $60.26 Median $302.00 Typical High $575.44 | Professional | None | $60.26 | $302.00 | $575.44 |
Wellpoint Setting Professional Modifier None Typical Low $186.21 Median $186.21 Typical High $257.04 | Professional | None | $186.21 | $186.21 | $257.04 |
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 $114.82 Median $125.89 Typical High $141.25 | Professional | 52 · Reduced service | $114.82 | $125.89 | $141.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $50.12 Typical High $57.54 | Professional | 53 · Discontinued | $45.71 | $50.12 | $57.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $169.82 Median $190.55 Typical High $213.80 | Professional | 54 · Surgery only | $169.82 | $190.55 | $213.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $38.02 Typical High $42.66 | Professional | 55 · Aftercare only | $34.67 | $38.02 | $42.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $25.12 Typical High $28.84 | Professional | 56 · Pre-op care only | $22.91 | $25.12 | $28.84 |
Where Florida sits
The same service costs 32.0 times more in Maine 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
ME $26,674MT $834
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.