How much rates vary
Facilitymedian $2,291 · 10th to 90th $955 to $10,471Professionalmedian $724 · 10th to 90th $85 to $1,380
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 $758.58 Median $4,786.30 Typical High $11,748.98 | Facility | None | $758.58 | $4,786.30 | $11,748.98 |
Aetna Setting Professional Modifier None Typical Low $758.58 Median $870.96 Typical High $1,023.29 | Professional | None | $758.58 | $870.96 | $1,023.29 |
AvMed Setting Facility Modifier None Typical Low $691.83 Median $2,089.30 Typical High $9,772.37 | Facility | None | $691.83 | $2,089.30 | $9,772.37 |
AvMed Setting Professional Modifier None Typical Low $691.83 Median $870.96 Typical High $1,023.29 | Professional | None | $691.83 | $870.96 | $1,023.29 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $1,698.24 Typical High $2,691.53 | Facility | None | $501.19 | $1,698.24 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $660.69 Median $691.83 Typical High $1,258.93 | Professional | None | $660.69 | $691.83 | $1,258.93 |
Florida Blue Setting Facility Modifier None Typical Low $1,230.27 Median $2,691.53 Typical High $11,748.98 | Facility | None | $1,230.27 | $2,691.53 | $11,748.98 |
Florida Blue Setting Professional Modifier None Typical Low $426.58 Median $707.95 Typical High $1,000.00 | Professional | None | $426.58 | $707.95 | $1,000.00 |
Molina Setting Professional Modifier None Typical Low $54.95 Median $645.65 Typical High $1,513.56 | Professional | None | $54.95 | $645.65 | $1,513.56 |
United Setting Facility Modifier None Typical Low $954.99 Median $2,398.83 Typical High $10,000.00 | Facility | None | $954.99 | $2,398.83 | $10,000.00 |
United Setting Professional Modifier None Typical Low $645.65 Median $812.83 Typical High $1,348.96 | Professional | None | $645.65 | $812.83 | $1,348.96 |
Wellpoint Setting Professional Modifier None Typical Low $645.65 Median $645.65 Typical High $645.65 | Professional | None | $645.65 | $645.65 | $645.65 |
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 $380.19 Median $436.52 Typical High $489.78 | Professional | 52 · Reduced service | $380.19 | $436.52 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $173.78 Typical High $194.98 | Professional | 53 · Discontinued | $151.36 | $173.78 | $194.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $645.65 Typical High $724.44 | Professional | 54 · Surgery only | $562.34 | $645.65 | $724.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $131.83 Typical High $147.91 | Professional | 55 · Aftercare only | $112.20 | $131.83 | $147.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $87.10 Typical High $97.72 | Professional | 56 · Pre-op care only | $75.86 | $87.10 | $97.72 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $602.56 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $524.81 | $602.56 | $676.08 |
Where Florida sits
The same service costs 2.8 times more in Alaska 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
AK $7,236MD $2,555
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.