How much rates vary
Facilitymedian $2,399 · 10th to 90th $437 to $24,547Professionalmedian $646 · 10th to 90th $87 to $1,202
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 $707.95 Median $3,890.45 Typical High $12,022.64 | Facility | None | $707.95 | $3,890.45 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $616.60 Median $724.44 Typical High $891.25 | Professional | None | $616.60 | $724.44 | $891.25 |
AvMed Setting Facility Modifier None Typical Low $630.96 Median $2,137.96 Typical High $11,748.98 | Facility | None | $630.96 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $616.60 Median $741.31 Typical High $912.01 | Professional | None | $616.60 | $741.31 | $912.01 |
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 $562.34 Median $602.56 Typical High $1,071.52 | Professional | None | $562.34 | $602.56 | $1,071.52 |
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 $354.81 Median $758.58 Typical High $891.25 | Professional | None | $354.81 | $758.58 | $891.25 |
Molina Setting Professional Modifier None Typical Low $54.95 Median $616.60 Typical High $1,412.54 | Professional | None | $54.95 | $616.60 | $1,412.54 |
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 $537.03 Median $691.83 Typical High $1,148.15 | Professional | None | $537.03 | $691.83 | $1,148.15 |
Wellpoint Setting Professional Modifier None Typical Low $575.44 Median $575.44 Typical High $575.44 | Professional | None | $575.44 | $575.44 | $575.44 |
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 $309.03 Median $363.08 Typical High $416.87 | Professional | 52 · Reduced service | $309.03 | $363.08 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $144.54 Typical High $165.96 | Professional | 53 · Discontinued | $123.03 | $144.54 | $165.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $537.03 Typical High $616.60 | Professional | 54 · Surgery only | $467.74 | $537.03 | $616.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $107.15 Typical High $123.03 | Professional | 55 · Aftercare only | $93.33 | $107.15 | $123.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $72.44 Typical High $83.18 | Professional | 56 · Pre-op care only | $61.66 | $72.44 | $83.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $501.19 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $436.52 | $501.19 | $575.44 |
Where Florida sits
The same service costs 12.3 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 $16,849MD $1,375
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.