How much rates vary
Facilitymedian $1,380 · 10th to 90th $468 to $11,749Professionalmedian $158 · 10th to 90th $112 to $257
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 $602.56 Median $3,890.45 Typical High $10,964.78 | Facility | None | $602.56 | $3,890.45 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $158.49 Median $173.78 Typical High $194.98 | Professional | None | $158.49 | $173.78 | $194.98 |
AvMed Setting Facility Modifier None Typical Low $165.96 Median $2,137.96 Typical High $11,748.98 | Facility | None | $165.96 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $128.82 Median $147.91 Typical High $194.98 | Professional | None | $128.82 | $147.91 | $194.98 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $2,344.23 Typical High $3,801.89 | Facility | None | $512.86 | $2,344.23 | $3,801.89 |
Cigna Setting Professional Modifier None Typical Low $131.83 Median $138.04 Typical High $269.15 | Professional | None | $131.83 | $138.04 | $269.15 |
Florida Blue Setting Facility Modifier None Typical Low $524.81 Median $1,096.48 Typical High $16,982.44 | Facility | None | $524.81 | $1,096.48 | $16,982.44 |
Florida Blue Setting Professional Modifier None Typical Low $87.10 Median $177.83 Typical High $204.17 | Professional | None | $87.10 | $177.83 | $204.17 |
Molina Setting Professional Modifier None Typical Low $104.71 Median $117.49 Typical High $288.40 | Professional | None | $104.71 | $117.49 | $288.40 |
United Setting Facility Modifier None Typical Low $398.11 Median $1,000.00 Typical High $5,623.41 | Facility | None | $398.11 | $1,000.00 | $5,623.41 |
United Setting Professional Modifier None Typical Low $131.83 Median $169.82 Typical High $281.84 | Professional | None | $131.83 | $169.82 | $281.84 |
Wellpoint Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $128.82 | Professional | None | $128.82 | $128.82 | $128.82 |
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 $79.43 Median $87.10 Typical High $97.72 | Professional | 52 · Reduced service | $79.43 | $87.10 | $97.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $34.67 Typical High $38.90 | Professional | 53 · Discontinued | $31.62 | $34.67 | $38.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $120.23 Median $131.83 Typical High $147.91 | Professional | 54 · Surgery only | $120.23 | $131.83 | $147.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $26.30 Typical High $29.51 | Professional | 55 · Aftercare only | $23.99 | $26.30 | $29.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $17.38 Typical High $19.50 | Professional | 56 · Pre-op care only | $15.85 | $17.38 | $19.50 |
Where Florida sits
The same service costs 9.8 times more in Alabama 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
AL $5,589MT $570
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.