How much rates vary
Facilitymedian $4,467 · 10th to 90th $776 to $19,498Professionalmedian $1,148 · 10th to 90th $195 to $2,138
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 $870.96 Median $6,918.31 Typical High $13,803.84 | Facility | None | $870.96 | $6,918.31 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $1,148.15 Median $1,348.96 Typical High $1,659.59 | Professional | None | $1,148.15 | $1,348.96 | $1,659.59 |
Ambetter Setting Professional Modifier None Typical Low $1,288.25 Median $1,621.81 Typical High $1,819.70 | Professional | None | $1,288.25 | $1,621.81 | $1,819.70 |
AvMed Setting Facility Modifier None Typical Low $1,096.48 Median $2,137.96 Typical High $11,748.98 | Facility | None | $1,096.48 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $1,096.48 Median $1,380.38 Typical High $1,584.89 | Professional | None | $1,096.48 | $1,380.38 | $1,584.89 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $524.81 Typical High $5,128.61 | Facility | None | $398.11 | $524.81 | $5,128.61 |
Cigna Setting Professional Modifier None Typical Low $1,023.29 Median $1,096.48 Typical High $1,949.84 | Professional | None | $1,023.29 | $1,096.48 | $1,949.84 |
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 $660.69 Median $1,380.38 Typical High $1,584.89 | Professional | None | $660.69 | $1,380.38 | $1,584.89 |
Molina Setting Professional Modifier None Typical Low $128.82 Median $1,047.13 Typical High $2,398.83 | Professional | None | $128.82 | $1,047.13 | $2,398.83 |
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 $977.24 Median $1,258.93 Typical High $2,089.30 | Professional | None | $977.24 | $1,258.93 | $2,089.30 |
Wellpoint Setting Professional Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $1,000.00 | Professional | None | $1,000.00 | $1,000.00 | $1,000.00 |
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 $575.44 Median $676.08 Typical High $758.58 | Professional | 52 · Reduced service | $575.44 | $676.08 | $758.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $229.09 Median $269.15 Typical High $302.00 | Professional | 53 · Discontinued | $229.09 | $269.15 | $302.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $1,023.29 Typical High $1,122.02 | Professional | 54 · Surgery only | $870.96 | $1,023.29 | $1,122.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $204.17 Typical High $223.87 | Professional | 55 · Aftercare only | $173.78 | $204.17 | $223.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $134.90 Typical High $151.36 | Professional | 56 · Pre-op care only | $114.82 | $134.90 | $151.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $954.99 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $812.83 | $954.99 | $1,047.13 |
Where Florida sits
The same service costs 8.5 times more in Maine than in Delaware. 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 $28,081DE $3,299
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.