How much rates vary
Facilitymedian $1,995 · 10th to 90th $776 to $7,413Professionalmedian $282 · 10th to 90th $204 to $537
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 $5,888.44 Typical High $12,022.64 | Facility | None | $776.25 | $5,888.44 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $251.19 Median $269.15 Typical High $478.63 | Professional | None | $251.19 | $269.15 | $478.63 |
AvMed Setting Facility Modifier None Typical Low $501.19 Median $2,137.96 Typical High $9,772.37 | Facility | None | $501.19 | $2,137.96 | $9,772.37 |
AvMed Setting Professional Modifier None Typical Low $229.09 Median $295.12 Typical High $323.59 | Professional | None | $229.09 | $295.12 | $323.59 |
Cigna Setting Facility Modifier None Typical Low $616.60 Median $1,174.90 Typical High $3,311.31 | Facility | None | $616.60 | $1,174.90 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $204.17 Median $295.12 Typical High $562.34 | Professional | None | $204.17 | $295.12 | $562.34 |
Florida Blue Setting Facility Modifier None Typical Low $1,000.00 Median $2,187.76 Typical High $7,413.10 | Facility | None | $1,000.00 | $2,187.76 | $7,413.10 |
Florida Blue Setting Professional Modifier None Typical Low $194.98 Median $208.93 Typical High $354.81 | Professional | None | $194.98 | $208.93 | $354.81 |
Molina Setting Professional Modifier None Typical Low $194.98 Median $281.84 Typical High $549.54 | Professional | None | $194.98 | $281.84 | $549.54 |
United Setting Facility Modifier None Typical Low $794.33 Median $1,778.28 Typical High $7,585.78 | Facility | None | $794.33 | $1,778.28 | $7,585.78 |
United Setting Professional Modifier None Typical Low $60.26 Median $316.23 Typical High $602.56 | Professional | None | $60.26 | $316.23 | $602.56 |
Wellpoint Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $275.42 | Professional | None | $213.80 | $213.80 | $275.42 |
7 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 $125.89 Median $134.90 Typical High $169.82 | Professional | 52 · Reduced service | $125.89 | $134.90 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $50.12 Median $53.70 Typical High $67.61 | Professional | 53 · Discontinued | $50.12 | $53.70 | $67.61 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $186.21 Median $199.53 Typical High $251.19 | Professional | 54 · Surgery only | $186.21 | $199.53 | $251.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.02 Median $39.81 Typical High $50.12 | Professional | 55 · Aftercare only | $38.02 | $39.81 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.12 Median $26.92 Typical High $33.88 | Professional | 56 · Pre-op care only | $25.12 | $26.92 | $33.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $173.78 Median $186.21 Typical High $234.42 | Professional | 78 · Unplanned return to OR | $173.78 | $186.21 | $234.42 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $371.54 Median $371.54 Typical High $371.54 | Professional | 59 · Distinct service | $371.54 | $371.54 | $371.54 |
Where Florida sits
The same service costs 6.6 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 $6,126MT $925
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.