How much rates vary
Facilitymedian $2,692 · 10th to 90th $447 to $25,119Professionalmedian $1,072 · 10th to 90th $117 to $2,042
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 $891.25 Median $6,025.60 Typical High $13,803.84 | Facility | None | $891.25 | $6,025.60 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $1,047.13 Median $1,122.02 Typical High $2,137.96 | Professional | None | $1,047.13 | $1,122.02 | $2,137.96 |
Ambetter Setting Professional Modifier None Typical Low $229.09 Median $1,862.09 Typical High $1,949.84 | Professional | None | $229.09 | $1,862.09 | $1,949.84 |
AvMed Setting Facility Modifier None Typical Low $891.25 Median $2,137.96 Typical High $13,182.57 | Facility | None | $891.25 | $2,137.96 | $13,182.57 |
AvMed Setting Professional Modifier None Typical Low $933.25 Median $1,230.27 Typical High $1,380.38 | Professional | None | $933.25 | $1,230.27 | $1,380.38 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $616.60 Typical High $11,748.98 | Facility | None | $398.11 | $616.60 | $11,748.98 |
Cigna Setting Professional Modifier None Typical Low $851.14 Median $1,202.26 Typical High $2,344.23 | Professional | None | $851.14 | $1,202.26 | $2,344.23 |
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 $776.25 Median $831.76 Typical High $1,288.25 | Professional | None | $776.25 | $831.76 | $1,288.25 |
Molina Setting Professional Modifier None Typical Low $104.71 Median $1,000.00 Typical High $1,995.26 | Professional | None | $104.71 | $1,000.00 | $1,995.26 |
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 $60.26 Median $1,348.96 Typical High $2,511.89 | Professional | None | $60.26 | $1,348.96 | $2,511.89 |
Wellpoint Setting Professional Modifier None Typical Low $831.76 Median $831.76 Typical High $1,122.02 | Professional | None | $831.76 | $831.76 | $1,122.02 |
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 $524.81 Median $562.34 Typical High $707.95 | Professional | 52 · Reduced service | $524.81 | $562.34 | $707.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $208.93 Median $223.87 Typical High $281.84 | Professional | 53 · Discontinued | $208.93 | $223.87 | $281.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $794.33 Median $831.76 Typical High $1,047.13 | Professional | 54 · Surgery only | $794.33 | $831.76 | $1,047.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $169.82 Typical High $208.93 | Professional | 55 · Aftercare only | $158.49 | $169.82 | $208.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $104.71 Median $112.20 Typical High $141.25 | Professional | 56 · Pre-op care only | $104.71 | $112.20 | $141.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $741.31 Median $776.25 Typical High $977.24 | Professional | 78 · Unplanned return to OR | $741.31 | $776.25 | $977.24 |
Where Florida sits
The same service costs 14.8 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 $28,001MD $1,894
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.