How much rates vary
Facilitymedian $2,344 · 10th to 90th $1,023 to $12,023Professionalmedian $490 · 10th to 90th $85 to $912
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 $6,025.60 Typical High $12,022.64 | Facility | None | $776.25 | $6,025.60 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $478.63 Median $575.44 Typical High $676.08 | Professional | None | $478.63 | $575.44 | $676.08 |
Ambetter Setting Professional Modifier None Typical Low $257.04 Median $794.33 Typical High $794.33 | Professional | None | $257.04 | $794.33 | $794.33 |
AvMed Setting Facility Modifier None Typical Low $588.84 Median $2,137.96 Typical High $9,772.37 | Facility | None | $588.84 | $2,137.96 | $9,772.37 |
AvMed Setting Professional Modifier None Typical Low $478.63 Median $575.44 Typical High $676.08 | Professional | None | $478.63 | $575.44 | $676.08 |
Cigna Setting Facility Modifier None Typical Low $616.60 Median $2,041.74 Typical High $3,311.31 | Facility | None | $616.60 | $2,041.74 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $436.52 Median $467.74 Typical High $831.76 | Professional | None | $436.52 | $467.74 | $831.76 |
Florida Blue Setting Facility Modifier None Typical Low $1,230.27 Median $2,630.27 Typical High $16,982.44 | Facility | None | $1,230.27 | $2,630.27 | $16,982.44 |
Florida Blue Setting Professional Modifier None Typical Low $275.42 Median $562.34 Typical High $691.83 | Professional | None | $275.42 | $562.34 | $691.83 |
Molina Setting Professional Modifier None Typical Low $54.95 Median $467.74 Typical High $1,071.52 | Professional | None | $54.95 | $467.74 | $1,071.52 |
United Setting Facility Modifier None Typical Low $954.99 Median $2,344.23 Typical High $10,000.00 | Facility | None | $954.99 | $2,344.23 | $10,000.00 |
United Setting Professional Modifier None Typical Low $407.38 Median $524.81 Typical High $870.96 | Professional | None | $407.38 | $524.81 | $870.96 |
Wellpoint Setting Professional Modifier None Typical Low $446.68 Median $446.68 Typical High $446.68 | Professional | None | $446.68 | $446.68 | $446.68 |
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 $239.88 Median $288.40 Typical High $316.23 | Professional | 52 · Reduced service | $239.88 | $288.40 | $316.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $114.82 Typical High $125.89 | Professional | 53 · Discontinued | $95.50 | $114.82 | $125.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $354.81 Median $426.58 Typical High $478.63 | Professional | 54 · Surgery only | $354.81 | $426.58 | $478.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $85.11 Typical High $95.50 | Professional | 55 · Aftercare only | $70.79 | $85.11 | $95.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $57.54 Typical High $63.10 | Professional | 56 · Pre-op care only | $47.86 | $57.54 | $63.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $331.13 Median $398.11 Typical High $446.68 | Professional | 78 · Unplanned return to OR | $331.13 | $398.11 | $446.68 |
Where Florida sits
The same service costs 4.0 times more in Oklahoma 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
OK $7,771MT $1,932
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.