How much rates vary
Facilitymedian $2,884 · 10th to 90th $1,122 to $13,490Professionalmedian $263 · 10th to 90th $200 to $427
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 $645.65 Median $5,011.87 Typical High $12,022.64 | Facility | None | $645.65 | $5,011.87 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $269.15 Median $288.40 Typical High $323.59 | Professional | None | $269.15 | $288.40 | $323.59 |
AvMed Setting Facility Modifier None Typical Low $501.19 Median $2,137.96 Typical High $9,772.37 | Facility | None | $501.19 | $2,137.96 | $9,772.37 |
AvMed Setting Professional Modifier None Typical Low $213.80 Median $263.03 Typical High $338.84 | Professional | None | $213.80 | $263.03 | $338.84 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $3,162.28 Typical High $6,025.60 | Facility | None | $501.19 | $3,162.28 | $6,025.60 |
Cigna Setting Professional Modifier None Typical Low $199.53 Median $208.93 Typical High $426.58 | Professional | None | $199.53 | $208.93 | $426.58 |
Florida Blue Setting Facility Modifier None Typical Low $1,318.26 Median $2,630.27 Typical High $16,982.44 | Facility | None | $1,318.26 | $2,630.27 | $16,982.44 |
Florida Blue Setting Professional Modifier None Typical Low $158.49 Median $309.03 Typical High $380.19 | Professional | None | $158.49 | $309.03 | $380.19 |
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 $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 $199.53 Median $269.15 Typical High $436.52 | Professional | None | $199.53 | $269.15 | $436.52 |
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 $134.90 Median $144.54 Typical High $158.49 | Professional | 52 · Reduced service | $134.90 | $144.54 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $53.70 Median $57.54 Typical High $63.10 | Professional | 53 · Discontinued | $53.70 | $57.54 | $63.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $204.17 Median $213.80 Typical High $239.88 | Professional | 54 · Surgery only | $204.17 | $213.80 | $239.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $42.66 Typical High $47.86 | Professional | 55 · Aftercare only | $40.74 | $42.66 | $47.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $28.84 Typical High $31.62 | Professional | 56 · Pre-op care only | $26.92 | $28.84 | $31.62 |
Where Florida sits
The same service costs 10.4 times more in Wyoming 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
WY $8,979MT $863
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.