How much rates vary
Facilitymedian $2,570 · 10th to 90th $912 to $11,749Professionalmedian $437 · 10th to 90th $339 to $724
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 $4,677.35 Typical High $11,481.54 | Facility | None | $602.56 | $4,677.35 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $436.52 Median $457.09 Typical High $562.34 | Professional | None | $436.52 | $457.09 | $562.34 |
Ambetter Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $588.84 | Professional | None | $389.05 | $389.05 | $588.84 |
AvMed Setting Facility Modifier None Typical Low $501.19 Median $2,137.96 Typical High $9,772.37 | Facility | None | $501.19 | $2,137.96 | $9,772.37 |
AvMed Setting Professional Modifier None Typical Low $331.13 Median $380.19 Typical High $501.19 | Professional | None | $331.13 | $380.19 | $501.19 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $4,265.80 Typical High $6,760.83 | Facility | None | $501.19 | $4,265.80 | $6,760.83 |
Cigna Setting Professional Modifier None Typical Low $338.84 Median $354.81 Typical High $691.83 | Professional | None | $338.84 | $354.81 | $691.83 |
Florida Blue Setting Facility Modifier None Typical Low $1,318.26 Median $2,630.27 Typical High $16,982.44 | Facility | None | $1,318.26 | $2,630.27 | $16,982.44 |
Florida Blue Setting Professional Modifier None Typical Low $245.47 Median $501.19 Typical High $575.44 | Professional | None | $245.47 | $501.19 | $575.44 |
Molina Setting Professional Modifier None Typical Low $338.84 Median $389.05 Typical High $933.25 | Professional | None | $338.84 | $389.05 | $933.25 |
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 $346.74 Median $446.68 Typical High $758.58 | Professional | None | $346.74 | $446.68 | $758.58 |
Wellpoint Setting Professional Modifier None Typical Low $323.59 Median $323.59 Typical High $323.59 | Professional | None | $323.59 | $323.59 | $323.59 |
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 $218.78 Median $229.09 Typical High $263.03 | Professional | 52 · Reduced service | $218.78 | $229.09 | $263.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $87.10 Median $91.20 Typical High $104.71 | Professional | 53 · Discontinued | $87.10 | $91.20 | $104.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $331.13 Median $346.74 Typical High $389.05 | Professional | 54 · Surgery only | $331.13 | $346.74 | $389.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $69.18 Typical High $77.62 | Professional | 55 · Aftercare only | $66.07 | $69.18 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $45.71 Typical High $52.48 | Professional | 56 · Pre-op care only | $43.65 | $45.71 | $52.48 |
Where Florida sits
The same service costs 5.9 times more in Alaska 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
AK $8,723MT $1,483
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.