How much rates vary
Facilitymedian $1,148 · 10th to 90th $457 to $6,607Professionalmedian $257 · 10th to 90th $200 to $417
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 $549.54 Median $3,801.89 Typical High $10,964.78 | Facility | None | $549.54 | $3,801.89 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $257.04 Median $275.42 Typical High $323.59 | Professional | None | $257.04 | $275.42 | $323.59 |
AvMed Setting Facility Modifier None Typical Low $446.68 Median $1,584.89 Typical High $9,549.93 | Facility | None | $446.68 | $1,584.89 | $9,549.93 |
AvMed Setting Professional Modifier None Typical Low $204.17 Median $257.04 Typical High $323.59 | Professional | None | $204.17 | $257.04 | $323.59 |
Cigna Setting Facility Modifier None Typical Low $436.52 Median $1,047.13 Typical High $2,187.76 | Facility | None | $436.52 | $1,047.13 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $199.53 Median $208.93 Typical High $407.38 | Professional | None | $199.53 | $208.93 | $407.38 |
Florida Blue Setting Facility Modifier None Typical Low $512.86 Median $1,071.52 Typical High $7,413.10 | Facility | None | $512.86 | $1,071.52 | $7,413.10 |
Florida Blue Setting Professional Modifier None Typical Low $147.91 Median $295.12 Typical High $346.74 | Professional | None | $147.91 | $295.12 | $346.74 |
Molina Setting Professional Modifier None Typical Low $208.93 Median $257.04 Typical High $575.44 | Professional | None | $208.93 | $257.04 | $575.44 |
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 $204.17 Median $263.03 Typical High $426.58 | Professional | None | $204.17 | $263.03 | $426.58 |
Wellpoint Setting Professional Modifier None Typical Low $194.98 Median $194.98 Typical High $194.98 | Professional | None | $194.98 | $194.98 | $194.98 |
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 $128.82 Median $134.90 Typical High $154.88 | Professional | 52 · Reduced service | $128.82 | $134.90 | $154.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $52.48 Median $54.95 Typical High $61.66 | Professional | 53 · Discontinued | $52.48 | $54.95 | $61.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $194.98 Median $204.17 Typical High $229.09 | Professional | 54 · Surgery only | $194.98 | $204.17 | $229.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $40.74 Typical High $46.77 | Professional | 55 · Aftercare only | $38.90 | $40.74 | $46.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $27.54 Typical High $30.90 | Professional | 56 · Pre-op care only | $25.70 | $27.54 | $30.90 |
Where Florida sits
The same service costs 5.2 times more in Oklahoma 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
OK $4,508MT $873
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.