How much rates vary
Facilitymedian $3,548 · 10th to 90th $501 to $20,417Professionalmedian $891 · 10th to 90th $129 to $1,585
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 $891.25 Median $4,897.79 Typical High $12,022.64 | Facility | None | $891.25 | $4,897.79 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $891.25 Median $1,047.13 Typical High $1,174.90 | Professional | None | $891.25 | $1,047.13 | $1,174.90 |
AvMed Setting Facility Modifier None Typical Low $851.14 Median $2,137.96 Typical High $11,748.98 | Facility | None | $851.14 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $851.14 Median $1,047.13 Typical High $1,230.27 | Professional | None | $851.14 | $1,047.13 | $1,230.27 |
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 $776.25 Median $831.76 Typical High $1,513.56 | Professional | None | $776.25 | $831.76 | $1,513.56 |
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 $512.86 Median $891.25 Typical High $1,230.27 | Professional | None | $512.86 | $891.25 | $1,230.27 |
Molina Setting Professional Modifier None Typical Low $81.28 Median $794.33 Typical High $1,819.70 | Professional | None | $81.28 | $794.33 | $1,819.70 |
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 $758.58 Median $954.99 Typical High $1,621.81 | Professional | None | $758.58 | $954.99 | $1,621.81 |
Wellpoint Setting Professional Modifier None Typical Low $776.25 Median $776.25 Typical High $776.25 | Professional | None | $776.25 | $776.25 | $776.25 |
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 $446.68 Median $524.81 Typical High $588.84 | Professional | 52 · Reduced service | $446.68 | $524.81 | $588.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $208.93 Typical High $234.42 | Professional | 53 · Discontinued | $177.83 | $208.93 | $234.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $794.33 Typical High $870.96 | Professional | 54 · Surgery only | $676.08 | $794.33 | $870.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $158.49 Typical High $173.78 | Professional | 55 · Aftercare only | $134.90 | $158.49 | $173.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $104.71 Typical High $117.49 | Professional | 56 · Pre-op care only | $89.13 | $104.71 | $117.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $741.31 Typical High $812.83 | Professional | 78 · Unplanned return to OR | $630.96 | $741.31 | $812.83 |
Where Florida sits
The same service costs 10.2 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 $17,229MD $1,684
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.