How much rates vary
Facilitymedian $3,548 · 10th to 90th $501 to $20,417Professionalmedian $1,445 · 10th to 90th $234 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 $776.25 Median $3,890.45 Typical High $12,022.64 | Facility | None | $776.25 | $3,890.45 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $1,479.11 Median $1,737.80 Typical High $2,137.96 | Professional | None | $1,479.11 | $1,737.80 | $2,137.96 |
Ambetter Setting Professional Modifier None Typical Low $1,445.44 Median $1,445.44 Typical High $1,445.44 | Professional | None | $1,445.44 | $1,445.44 | $1,445.44 |
AvMed Setting Facility Modifier None Typical Low $1,380.38 Median $2,137.96 Typical High $11,748.98 | Facility | None | $1,380.38 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $1,380.38 Median $1,698.24 Typical High $1,995.26 | Professional | None | $1,380.38 | $1,698.24 | $1,995.26 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $501.19 Typical High $2,691.53 | Facility | None | $398.11 | $501.19 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $1,288.25 Median $1,380.38 Typical High $2,454.71 | Professional | None | $1,288.25 | $1,380.38 | $2,454.71 |
Florida Blue Setting Facility Modifier None Typical Low $2,818.38 Median $5,888.44 Typical High $25,703.96 | Facility | None | $2,818.38 | $5,888.44 | $25,703.96 |
Florida Blue Setting Professional Modifier None Typical Low $851.14 Median $1,288.25 Typical High $1,995.26 | Professional | None | $851.14 | $1,288.25 | $1,995.26 |
Molina Setting Professional Modifier None Typical Low $154.88 Median $1,288.25 Typical High $3,019.95 | Professional | None | $154.88 | $1,288.25 | $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 $1,230.27 Median $1,584.89 Typical High $2,630.27 | Professional | None | $1,230.27 | $1,584.89 | $2,630.27 |
Wellpoint Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,258.93 | Professional | None | $1,258.93 | $1,258.93 | $1,258.93 |
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 $741.31 Median $870.96 Typical High $954.99 | Professional | 52 · Reduced service | $741.31 | $870.96 | $954.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $295.12 Median $346.74 Typical High $389.05 | Professional | 53 · Discontinued | $295.12 | $346.74 | $389.05 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,096.48 Median $1,288.25 Typical High $1,445.44 | Professional | 54 · Surgery only | $1,096.48 | $1,288.25 | $1,445.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $218.78 Median $257.04 Typical High $288.40 | Professional | 55 · Aftercare only | $218.78 | $257.04 | $288.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $147.91 Median $173.78 Typical High $190.55 | Professional | 56 · Pre-op care only | $147.91 | $173.78 | $190.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,023.29 Median $1,202.26 Typical High $1,348.96 | Professional | 78 · Unplanned return to OR | $1,023.29 | $1,202.26 | $1,348.96 |
Where Florida sits
The same service costs 7.6 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 $18,140MD $2,382
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.