How much rates vary
Facilitymedian $2,291 · 10th to 90th $437 to $24,547Professionalmedian $1,230 · 10th to 90th $112 to $2,344
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 $1,230.27 Median $1,288.25 Typical High $1,659.59 | Professional | None | $1,230.27 | $1,288.25 | $1,659.59 |
AvMed Setting Facility Modifier None Typical Low $1,023.29 Median $2,137.96 Typical High $11,748.98 | Facility | None | $1,023.29 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $1,071.52 Median $1,412.54 Typical High $1,584.89 | Professional | None | $1,071.52 | $1,412.54 | $1,584.89 |
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 $977.24 Median $1,380.38 Typical High $2,691.53 | Professional | None | $977.24 | $1,380.38 | $2,691.53 |
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 $891.25 Median $954.99 Typical High $1,548.82 | Professional | None | $891.25 | $954.99 | $1,548.82 |
Molina Setting Professional Modifier None Typical Low $104.71 Median $1,174.90 Typical High $2,344.23 | Professional | None | $104.71 | $1,174.90 | $2,344.23 |
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 $1,548.82 Typical High $2,951.21 | Professional | None | $60.26 | $1,548.82 | $2,951.21 |
Wellpoint Setting Professional Modifier None Typical Low $954.99 Median $954.99 Typical High $1,288.25 | Professional | None | $954.99 | $954.99 | $1,288.25 |
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 $616.60 Median $645.65 Typical High $812.83 | Professional | 52 · Reduced service | $616.60 | $645.65 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $245.47 Median $257.04 Typical High $323.59 | Professional | 53 · Discontinued | $245.47 | $257.04 | $323.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $954.99 Typical High $1,202.26 | Professional | 54 · Surgery only | $912.01 | $954.99 | $1,202.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $194.98 Typical High $239.88 | Professional | 55 · Aftercare only | $181.97 | $194.98 | $239.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $128.82 Typical High $162.18 | Professional | 56 · Pre-op care only | $123.03 | $128.82 | $162.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $891.25 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $851.14 | $891.25 | $1,122.02 |
Where Florida sits
The same service costs 12.0 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 $24,859MD $2,076
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.