How much rates vary
Facilitymedian $2,399 · 10th to 90th $437 to $24,547Professionalmedian $912 · 10th to 90th $129 to $1,698
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 $912.01 Median $1,071.52 Typical High $1,202.26 | Professional | None | $912.01 | $1,071.52 | $1,202.26 |
AvMed Setting Facility Modifier None Typical Low $891.25 Median $2,137.96 Typical High $11,748.98 | Facility | None | $891.25 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $891.25 Median $1,096.48 Typical High $1,318.26 | Professional | None | $891.25 | $1,096.48 | $1,318.26 |
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 $831.76 Median $870.96 Typical High $1,548.82 | Professional | None | $831.76 | $870.96 | $1,548.82 |
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 $524.81 Median $933.25 Typical High $1,288.25 | Professional | None | $524.81 | $933.25 | $1,288.25 |
Molina Setting Professional Modifier None Typical Low $81.28 Median $851.14 Typical High $1,949.84 | Professional | None | $81.28 | $851.14 | $1,949.84 |
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 $776.25 Median $1,000.00 Typical High $1,659.59 | Professional | None | $776.25 | $1,000.00 | $1,659.59 |
Wellpoint Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $812.83 | Professional | None | $812.83 | $812.83 | $812.83 |
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 $457.09 Median $537.03 Typical High $602.56 | Professional | 52 · Reduced service | $457.09 | $537.03 | $602.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $181.97 Median $218.78 Typical High $239.88 | Professional | 53 · Discontinued | $181.97 | $218.78 | $239.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $812.83 Typical High $912.01 | Professional | 54 · Surgery only | $691.83 | $812.83 | $912.01 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $162.18 Typical High $181.97 | Professional | 55 · Aftercare only | $138.04 | $162.18 | $181.97 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $107.15 Typical High $120.23 | Professional | 56 · Pre-op care only | $91.20 | $107.15 | $120.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $758.58 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $645.65 | $758.58 | $851.14 |
Where Florida sits
The same service costs 10.0 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 $17,294MD $1,737
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.