How much rates vary
Facilitymedian $5,129 · 10th to 90th $1,585 to $14,125Professionalmedian $794 · 10th to 90th $63 to $1,514
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 $812.83 Median $6,760.83 Typical High $13,803.84 | Facility | None | $812.83 | $6,760.83 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $812.83 Median $851.14 Typical High $1,174.90 | Professional | None | $812.83 | $851.14 | $1,174.90 |
Ambetter Setting Professional Modifier None Typical Low $144.54 Median $144.54 Typical High $144.54 | Professional | None | $144.54 | $144.54 | $144.54 |
AvMed Setting Facility Modifier None Typical Low $707.95 Median $4,365.16 Typical High $13,182.57 | Facility | None | $707.95 | $4,365.16 | $13,182.57 |
AvMed Setting Professional Modifier None Typical Low $707.95 Median $933.25 Typical High $1,047.13 | Professional | None | $707.95 | $933.25 | $1,047.13 |
Cigna Setting Facility Modifier None Typical Low $724.44 Median $5,370.32 Typical High $11,481.54 | Facility | None | $724.44 | $5,370.32 | $11,481.54 |
Cigna Setting Professional Modifier None Typical Low $645.65 Median $933.25 Typical High $1,778.28 | Professional | None | $645.65 | $933.25 | $1,778.28 |
Florida Blue Setting Facility Modifier None Typical Low $2,818.38 Median $5,495.41 Typical High $16,982.44 | Facility | None | $2,818.38 | $5,495.41 | $16,982.44 |
Florida Blue Setting Professional Modifier None Typical Low $588.84 Median $630.96 Typical High $977.24 | Professional | None | $588.84 | $630.96 | $977.24 |
Molina Setting Professional Modifier None Typical Low $54.95 Median $724.44 Typical High $1,479.11 | Professional | None | $54.95 | $724.44 | $1,479.11 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $3,311.31 Typical High $12,589.25 | Facility | None | $1,230.27 | $3,311.31 | $12,589.25 |
United Setting Professional Modifier None Typical Low $60.26 Median $1,023.29 Typical High $1,949.84 | Professional | None | $60.26 | $1,023.29 | $1,949.84 |
Wellpoint Setting Professional Modifier None Typical Low $645.65 Median $645.65 Typical High $851.14 | Professional | None | $645.65 | $645.65 | $851.14 |
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 $407.38 Median $426.58 Typical High $537.03 | Professional | 52 · Reduced service | $407.38 | $426.58 | $537.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $169.82 Typical High $213.80 | Professional | 53 · Discontinued | $162.18 | $169.82 | $213.80 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $602.56 Median $645.65 Typical High $812.83 | Professional | 54 · Surgery only | $602.56 | $645.65 | $812.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $128.82 Typical High $162.18 | Professional | 55 · Aftercare only | $120.23 | $128.82 | $162.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $85.11 Typical High $107.15 | Professional | 56 · Pre-op care only | $81.28 | $85.11 | $107.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $562.34 Median $602.56 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $562.34 | $602.56 | $758.58 |
Where Florida sits
The same service costs 4.6 times more in Wyoming 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
WY $13,103MT $2,825
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.