How much rates vary
Facilitymedian $3,311 · 10th to 90th $1,349 to $13,183Professionalmedian $1,288 · 10th to 90th $195 to $2,512
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 $851.14 Median $5,495.41 Typical High $12,882.50 | Facility | None | $851.14 | $5,495.41 | $12,882.50 |
Aetna Setting Professional Modifier None Typical Low $1,023.29 Median $1,202.26 Typical High $1,621.81 | Professional | None | $1,023.29 | $1,202.26 | $1,621.81 |
Ambetter Setting Professional Modifier None Typical Low $2,238.72 Median $2,238.72 Typical High $2,238.72 | Professional | None | $2,238.72 | $2,238.72 | $2,238.72 |
AvMed Setting Facility Modifier None Typical Low $724.44 Median $2,137.96 Typical High $9,772.37 | Facility | None | $724.44 | $2,137.96 | $9,772.37 |
AvMed Setting Professional Modifier None Typical Low $1,202.26 Median $1,348.96 Typical High $1,621.81 | Professional | None | $1,202.26 | $1,348.96 | $1,621.81 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $3,311.31 Typical High $5,370.32 | Facility | None | $707.95 | $3,311.31 | $5,370.32 |
Cigna Setting Professional Modifier None Typical Low $912.01 Median $1,348.96 Typical High $2,454.71 | Professional | None | $912.01 | $1,348.96 | $2,454.71 |
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 $1,023.29 Median $1,122.02 Typical High $1,445.44 | Professional | None | $1,023.29 | $1,122.02 | $1,445.44 |
Molina Setting Professional Modifier None Typical Low $138.04 Median $1,288.25 Typical High $2,691.53 | Professional | None | $138.04 | $1,288.25 | $2,691.53 |
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 $954.99 Median $1,513.56 Typical High $2,951.21 | Professional | None | $954.99 | $1,513.56 | $2,951.21 |
Wellpoint Setting Professional Modifier None Typical Low $831.76 Median $1,148.15 Typical High $1,148.15 | Professional | None | $831.76 | $1,148.15 | $1,148.15 |
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 $501.19 Median $588.84 Typical High $741.31 | Professional | 52 · Reduced service | $501.19 | $588.84 | $741.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $204.17 Median $234.42 Typical High $302.00 | Professional | 53 · Discontinued | $204.17 | $234.42 | $302.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $870.96 Typical High $1,122.02 | Professional | 54 · Surgery only | $758.58 | $870.96 | $1,122.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $173.78 Typical High $223.87 | Professional | 55 · Aftercare only | $151.36 | $173.78 | $223.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $117.49 Typical High $151.36 | Professional | 56 · Pre-op care only | $102.33 | $117.49 | $151.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $812.83 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $707.95 | $812.83 | $1,047.13 |
Where Florida sits
The same service costs 3.2 times more in Alaska 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
AK $12,311KY $3,892
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.