How much rates vary
Facilitymedian $5,754 · 10th to 90th $1,995 to $15,136Professionalmedian $4,074 · 10th to 90th $347 to $7,762
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 $1,000.00 Median $6,309.57 Typical High $15,135.61 | Facility | None | $1,000.00 | $6,309.57 | $15,135.61 |
Aetna Setting Professional Modifier None Typical Low $416.87 Median $4,786.30 Typical High $6,309.57 | Professional | None | $416.87 | $4,786.30 | $6,309.57 |
AvMed Setting Facility Modifier None Typical Low $630.96 Median $4,786.30 Typical High $11,748.98 | Facility | None | $630.96 | $4,786.30 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $416.87 Median $4,466.84 Typical High $6,165.95 | Professional | None | $416.87 | $4,466.84 | $6,165.95 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $7,244.36 Typical High $13,489.63 | Facility | None | $501.19 | $7,244.36 | $13,489.63 |
Cigna Setting Professional Modifier None Typical Low $316.23 Median $1,000.00 Typical High $6,309.57 | Professional | None | $316.23 | $1,000.00 | $6,309.57 |
Florida Blue Setting Facility Modifier None Typical Low $2,884.03 Median $5,888.44 Typical High $16,982.44 | Facility | None | $2,884.03 | $5,888.44 | $16,982.44 |
Florida Blue Setting Professional Modifier None Typical Low $3,467.37 Median $6,606.93 Typical High $7,943.28 | Professional | None | $3,467.37 | $6,606.93 | $7,943.28 |
Molina Setting Professional Modifier None Typical Low $457.09 Median $4,265.80 Typical High $10,471.29 | Professional | None | $457.09 | $4,265.80 | $10,471.29 |
United Setting Facility Modifier None Typical Low $1,584.89 Median $4,073.80 Typical High $15,488.17 | Facility | None | $1,584.89 | $4,073.80 | $15,488.17 |
United Setting Professional Modifier None Typical Low $354.81 Median $4,168.69 Typical High $8,128.31 | Professional | None | $354.81 | $4,168.69 | $8,128.31 |
Wellpoint Setting Professional Modifier None Typical Low $316.23 Median $407.38 Typical High $407.38 | Professional | None | $316.23 | $407.38 | $407.38 |
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 $204.17 Median $2,398.83 Typical High $3,162.28 | Professional | 52 · Reduced service | $204.17 | $2,398.83 | $3,162.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $977.24 Typical High $1,258.93 | Professional | 53 · Discontinued | $83.18 | $977.24 | $1,258.93 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $3,630.78 Typical High $4,786.30 | Professional | 54 · Surgery only | $309.03 | $3,630.78 | $4,786.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $724.44 Typical High $954.99 | Professional | 55 · Aftercare only | $61.66 | $724.44 | $954.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $478.63 Typical High $630.96 | Professional | 56 · Pre-op care only | $41.69 | $478.63 | $630.96 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $3,388.44 Typical High $4,466.84 | Professional | 78 · Unplanned return to OR | $288.40 | $3,388.44 | $4,466.84 |
Where Florida sits
The same service costs 4.1 times more in Iowa 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
IA $18,453DE $4,539
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.