How much rates vary
Facilitymedian $2,291 · 10th to 90th $437 to $24,547Professionalmedian $1,122 · 10th to 90th $112 to $2,138
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 $3,890.45 Typical High $12,022.64 | Facility | None | $776.25 | $3,890.45 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $1,096.48 Median $1,148.15 Typical High $1,479.11 | Professional | None | $1,096.48 | $1,148.15 | $1,479.11 |
AvMed Setting Facility Modifier None Typical Low $933.25 Median $2,137.96 Typical High $11,748.98 | Facility | None | $933.25 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $977.24 Median $1,288.25 Typical High $1,412.54 | Professional | None | $977.24 | $1,288.25 | $1,412.54 |
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 $891.25 Median $1,258.93 Typical High $2,398.83 | Professional | None | $891.25 | $1,258.93 | $2,398.83 |
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 $812.83 Median $870.96 Typical High $1,318.26 | Professional | None | $812.83 | $870.96 | $1,318.26 |
Molina Setting Professional Modifier None Typical Low $104.71 Median $1,047.13 Typical High $2,089.30 | Professional | None | $104.71 | $1,047.13 | $2,089.30 |
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 $1,380.38 Typical High $2,630.27 | Professional | None | $60.26 | $1,380.38 | $2,630.27 |
Wellpoint Setting Professional Modifier None Typical Low $870.96 Median $870.96 Typical High $1,174.90 | Professional | None | $870.96 | $870.96 | $1,174.90 |
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 $549.54 Median $575.44 Typical High $724.44 | Professional | 52 · Reduced service | $549.54 | $575.44 | $724.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $218.78 Median $234.42 Typical High $295.12 | Professional | 53 · Discontinued | $218.78 | $234.42 | $295.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $870.96 Typical High $1,096.48 | Professional | 54 · Surgery only | $812.83 | $870.96 | $1,096.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $173.78 Typical High $218.78 | Professional | 55 · Aftercare only | $162.18 | $173.78 | $218.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $114.82 Typical High $144.54 | Professional | 56 · Pre-op care only | $109.65 | $114.82 | $144.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $812.83 Typical High $1,023.29 | Professional | 78 · Unplanned return to OR | $758.58 | $812.83 | $1,023.29 |
Where Florida sits
The same service costs 9.0 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 $17,266MD $1,911
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.