How much rates vary
Facilitymedian $2,399 · 10th to 90th $437 to $24,547Professionalmedian $1,660 · 10th to 90th $229 to $3,020
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 $776.25 Median $3,890.45 Typical High $12,022.64 | Facility | None | $776.25 | $3,890.45 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $1,659.59 Median $1,949.84 Typical High $2,187.76 | Professional | None | $1,659.59 | $1,949.84 | $2,187.76 |
Ambetter Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $812.83 | Professional | None | $812.83 | $812.83 | $812.83 |
AvMed Setting Facility Modifier None Typical Low $1,445.44 Median $2,137.96 Typical High $11,748.98 | Facility | None | $1,445.44 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $1,584.89 Median $1,995.26 Typical High $2,344.23 | Professional | None | $1,584.89 | $1,995.26 | $2,344.23 |
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 $1,479.11 Median $1,584.89 Typical High $2,818.38 | Professional | None | $1,479.11 | $1,584.89 | $2,818.38 |
Florida Blue Setting Facility Modifier None Typical Low $10,471.29 Median $22,387.21 Typical High $33,884.42 | Facility | None | $10,471.29 | $22,387.21 | $33,884.42 |
Florida Blue Setting Professional Modifier None Typical Low $954.99 Median $1,621.81 Typical High $2,290.87 | Professional | None | $954.99 | $1,621.81 | $2,290.87 |
Molina Setting Professional Modifier None Typical Low $154.88 Median $1,513.56 Typical High $3,467.37 | Professional | None | $154.88 | $1,513.56 | $3,467.37 |
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 $1,412.54 Median $1,778.28 Typical High $2,951.21 | Professional | None | $1,412.54 | $1,778.28 | $2,951.21 |
Wellpoint Setting Professional Modifier None Typical Low $1,445.44 Median $1,445.44 Typical High $1,445.44 | Professional | None | $1,445.44 | $1,445.44 | $1,445.44 |
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 $831.76 Median $977.24 Typical High $1,096.48 | Professional | 52 · Reduced service | $831.76 | $977.24 | $1,096.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $331.13 Median $389.05 Typical High $436.52 | Professional | 53 · Discontinued | $331.13 | $389.05 | $436.52 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,258.93 Median $1,479.11 Typical High $1,621.81 | Professional | 54 · Surgery only | $1,258.93 | $1,479.11 | $1,621.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $251.19 Median $295.12 Typical High $331.13 | Professional | 55 · Aftercare only | $251.19 | $295.12 | $331.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $165.96 Median $194.98 Typical High $218.78 | Professional | 56 · Pre-op care only | $165.96 | $194.98 | $218.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,174.90 Median $1,380.38 Typical High $1,513.56 | Professional | 78 · Unplanned return to OR | $1,174.90 | $1,380.38 | $1,513.56 |
Where Florida sits
The same service costs 6.9 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 $18,419MD $2,652
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.