How much rates vary
Facilitymedian $1,905 · 10th to 90th $794 to $11,749Professionalmedian $427 · 10th to 90th $83 to $661
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 $501.19 Median $3,801.89 Typical High $10,964.78 | Facility | None | $501.19 | $3,801.89 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $331.13 Median $426.58 Typical High $549.54 | Professional | None | $331.13 | $426.58 | $549.54 |
AvMed Setting Facility Modifier None Typical Low $446.68 Median $1,479.11 Typical High $9,549.93 | Facility | None | $446.68 | $1,479.11 | $9,549.93 |
AvMed Setting Professional Modifier None Typical Low $389.05 Median $478.63 Typical High $630.96 | Professional | None | $389.05 | $478.63 | $630.96 |
Cigna Setting Facility Modifier None Typical Low $436.52 Median $1,698.24 Typical High $2,754.23 | Facility | None | $436.52 | $1,698.24 | $2,754.23 |
Cigna Setting Professional Modifier None Typical Low $309.03 Median $416.87 Typical High $676.08 | Professional | None | $309.03 | $416.87 | $676.08 |
Florida Blue Setting Facility Modifier None Typical Low $977.24 Median $2,089.30 Typical High $16,982.44 | Facility | None | $977.24 | $2,089.30 | $16,982.44 |
Florida Blue Setting Professional Modifier None Typical Low $398.11 Median $446.68 Typical High $645.65 | Professional | None | $398.11 | $446.68 | $645.65 |
Molina Setting Professional Modifier None Typical Low $37.15 Median $436.52 Typical High $691.83 | Professional | None | $37.15 | $436.52 | $691.83 |
United Setting Facility Modifier None Typical Low $794.33 Median $1,778.28 Typical High $7,585.78 | Facility | None | $794.33 | $1,778.28 | $7,585.78 |
United Setting Professional Modifier None Typical Low $269.15 Median $398.11 Typical High $758.58 | Professional | None | $269.15 | $398.11 | $758.58 |
Wellpoint Setting Professional Modifier None Typical Low $288.40 Median $436.52 Typical High $436.52 | Professional | None | $288.40 | $436.52 | $436.52 |
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 $165.96 Median $213.80 Typical High $245.47 | Professional | 52 · Reduced service | $165.96 | $213.80 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $85.11 Typical High $100.00 | Professional | 53 · Discontinued | $66.07 | $85.11 | $100.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $316.23 Typical High $371.54 | Professional | 54 · Surgery only | $245.47 | $316.23 | $371.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $63.10 Typical High $74.13 | Professional | 55 · Aftercare only | $48.98 | $63.10 | $74.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $42.66 Typical High $50.12 | Professional | 56 · Pre-op care only | $33.11 | $42.66 | $50.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $229.09 Median $295.12 Typical High $346.74 | Professional | 78 · Unplanned return to OR | $229.09 | $295.12 | $346.74 |
Where Florida sits
The same service costs 4.6 times more in Oklahoma 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
OK $6,614MT $1,440
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.