How much rates vary
Facilitymedian $2,399 · 10th to 90th $437 to $24,547Professionalmedian $1,230 · 10th to 90th $148 to $2,239
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 $1,318.26 Median $1,548.82 Typical High $1,949.84 | Professional | None | $1,318.26 | $1,548.82 | $1,949.84 |
Ambetter Setting Professional Modifier None Typical Low $1,445.44 Median $1,584.89 Typical High $1,584.89 | Professional | None | $1,445.44 | $1,584.89 | $1,584.89 |
AvMed Setting Facility Modifier None Typical Low $1,258.93 Median $2,137.96 Typical High $11,748.98 | Facility | None | $1,258.93 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $1,258.93 Median $1,548.82 Typical High $1,819.70 | Professional | None | $1,258.93 | $1,548.82 | $1,819.70 |
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 $1,174.90 Median $1,230.27 Typical High $2,238.72 | Professional | None | $1,174.90 | $1,230.27 | $2,238.72 |
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 $758.58 Median $1,122.02 Typical High $1,819.70 | Professional | None | $758.58 | $1,122.02 | $1,819.70 |
Molina Setting Professional Modifier None Typical Low $128.82 Median $1,071.52 Typical High $2,511.89 | Professional | None | $128.82 | $1,071.52 | $2,511.89 |
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 $1,122.02 Median $1,412.54 Typical High $2,344.23 | Professional | None | $1,122.02 | $1,412.54 | $2,344.23 |
Wellpoint Setting Professional Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $1,148.15 | Professional | None | $1,148.15 | $1,148.15 | $1,148.15 |
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 $660.69 Median $776.25 Typical High $870.96 | Professional | 52 · Reduced service | $660.69 | $776.25 | $870.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $309.03 Typical High $346.74 | Professional | 53 · Discontinued | $263.03 | $309.03 | $346.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,000.00 Median $1,174.90 Typical High $1,288.25 | Professional | 54 · Surgery only | $1,000.00 | $1,174.90 | $1,288.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $234.42 Typical High $257.04 | Professional | 55 · Aftercare only | $199.53 | $234.42 | $257.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $131.83 Median $154.88 Typical High $173.78 | Professional | 56 · Pre-op care only | $131.83 | $154.88 | $173.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $1,096.48 Typical High $1,202.26 | Professional | 78 · Unplanned return to OR | $933.25 | $1,096.48 | $1,202.26 |
Where Florida sits
The same service costs 8.1 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 $17,891MD $2,222
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.