How much rates vary
Facilitymedian $2,692 · 10th to 90th $447 to $25,119Professionalmedian $1,202 · 10th to 90th $115 to $2,291
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 $870.96 Median $6,456.54 Typical High $13,803.84 | Facility | None | $870.96 | $6,456.54 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $1,202.26 Median $1,258.93 Typical High $1,995.26 | Professional | None | $1,202.26 | $1,258.93 | $1,995.26 |
AvMed Setting Facility Modifier None Typical Low $977.24 Median $2,137.96 Typical High $13,182.57 | Facility | None | $977.24 | $2,137.96 | $13,182.57 |
AvMed Setting Professional Modifier None Typical Low $1,023.29 Median $1,380.38 Typical High $1,548.82 | Professional | None | $1,023.29 | $1,380.38 | $1,548.82 |
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 $954.99 Median $1,348.96 Typical High $2,630.27 | Professional | None | $954.99 | $1,348.96 | $2,630.27 |
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 $870.96 Median $933.25 Typical High $1,445.44 | Professional | None | $870.96 | $933.25 | $1,445.44 |
Molina Setting Professional Modifier None Typical Low $104.71 Median $1,122.02 Typical High $2,238.72 | Professional | None | $104.71 | $1,122.02 | $2,238.72 |
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 $1,479.11 Typical High $2,818.38 | Professional | None | $60.26 | $1,479.11 | $2,818.38 |
Wellpoint Setting Professional Modifier None Typical Low $933.25 Median $933.25 Typical High $1,230.27 | Professional | None | $933.25 | $933.25 | $1,230.27 |
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 $588.84 Median $630.96 Typical High $794.33 | Professional | 52 · Reduced service | $588.84 | $630.96 | $794.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $239.88 Median $251.19 Typical High $316.23 | Professional | 53 · Discontinued | $239.88 | $251.19 | $316.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $891.25 Median $933.25 Typical High $1,174.90 | Professional | 54 · Surgery only | $891.25 | $933.25 | $1,174.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $186.21 Typical High $234.42 | Professional | 55 · Aftercare only | $177.83 | $186.21 | $234.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $120.23 Median $125.89 Typical High $158.49 | Professional | 56 · Pre-op care only | $120.23 | $125.89 | $158.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $831.76 Median $870.96 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $831.76 | $870.96 | $1,096.48 |
Where Florida sits
The same service costs 13.9 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 $28,165MD $2,021
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.