How much rates vary
Facilitymedian $3,020 · 10th to 90th $447 to $27,542Professionalmedian $1,413 · 10th to 90th $229 to $2,692
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 $1,348.96 Median $5,011.87 Typical High $24,547.09 | Facility | None | $1,348.96 | $5,011.87 | $24,547.09 |
Aetna Setting Professional Modifier None Typical Low $1,348.96 Median $1,584.89 Typical High $1,905.46 | Professional | None | $1,348.96 | $1,584.89 | $1,905.46 |
AvMed Setting Facility Modifier None Typical Low $1,318.26 Median $2,137.96 Typical High $13,182.57 | Facility | None | $1,318.26 | $2,137.96 | $13,182.57 |
AvMed Setting Professional Modifier None Typical Low $1,318.26 Median $1,659.59 Typical High $1,949.84 | Professional | None | $1,318.26 | $1,659.59 | $1,949.84 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $562.34 Typical High $28,183.83 | Facility | None | $398.11 | $562.34 | $28,183.83 |
Cigna Setting Professional Modifier None Typical Low $1,230.27 Median $1,318.26 Typical High $2,290.87 | Professional | None | $1,230.27 | $1,318.26 | $2,290.87 |
Florida Blue Setting Facility Modifier None Typical Low $10,471.29 Median $22,387.21 Typical High $33,884.42 | Facility | None | $10,471.29 | $22,387.21 | $33,884.42 |
Florida Blue Setting Professional Modifier None Typical Low $794.33 Median $1,348.96 Typical High $1,905.46 | Professional | None | $794.33 | $1,348.96 | $1,905.46 |
Molina Setting Professional Modifier None Typical Low $165.96 Median $1,380.38 Typical High $3,019.95 | Professional | None | $165.96 | $1,380.38 | $3,019.95 |
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 $1,148.15 Median $1,445.44 Typical High $2,454.71 | Professional | None | $1,148.15 | $1,445.44 | $2,454.71 |
Wellpoint Setting Professional Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $1,202.26 | Professional | None | $1,202.26 | $1,202.26 | $1,202.26 |
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 $676.08 Median $794.33 Typical High $891.25 | Professional | 52 · Reduced service | $676.08 | $794.33 | $891.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $269.15 Median $316.23 Typical High $354.81 | Professional | 53 · Discontinued | $269.15 | $316.23 | $354.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,023.29 Median $1,202.26 Typical High $1,318.26 | Professional | 54 · Surgery only | $1,023.29 | $1,202.26 | $1,318.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $204.17 Median $239.88 Typical High $263.03 | Professional | 55 · Aftercare only | $204.17 | $239.88 | $263.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $134.90 Median $158.49 Typical High $177.83 | Professional | 56 · Pre-op care only | $134.90 | $158.49 | $177.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $954.99 Median $1,122.02 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $954.99 | $1,122.02 | $1,230.27 |
Where Florida sits
The same service costs 7.8 times more in Maine than in Maryland. 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 $17,987MD $2,300
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.