How much rates vary
Facilitymedian $1,905 · 10th to 90th $708 to $7,413Professionalmedian $269 · 10th to 90th $162 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 $501.19 Median $4,073.80 Typical High $10,964.78 | Facility | None | $501.19 | $4,073.80 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $177.83 Median $239.88 Typical High $389.05 | Professional | None | $177.83 | $239.88 | $389.05 |
Ambetter Setting Professional Modifier None Typical Low $208.93 Median $208.93 Typical High $208.93 | Professional | None | $208.93 | $208.93 | $208.93 |
AvMed Setting Facility Modifier None Typical Low $363.08 Median $1,513.56 Typical High $9,772.37 | Facility | None | $363.08 | $1,513.56 | $9,772.37 |
AvMed Setting Professional Modifier None Typical Low $199.53 Median $275.42 Typical High $363.08 | Professional | None | $199.53 | $275.42 | $363.08 |
Cigna Setting Facility Modifier None Typical Low $436.52 Median $1,174.90 Typical High $2,187.76 | Facility | None | $436.52 | $1,174.90 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $147.91 Median $257.04 Typical High $537.03 | Professional | None | $147.91 | $257.04 | $537.03 |
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 $208.93 Median $251.19 Typical High $354.81 | Professional | None | $208.93 | $251.19 | $354.81 |
Molina Setting Professional Modifier None Typical Low $251.19 Median $354.81 Typical High $707.95 | Professional | None | $251.19 | $354.81 | $707.95 |
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 $162.18 Median $295.12 Typical High $562.34 | Professional | None | $162.18 | $295.12 | $562.34 |
Wellpoint Setting Professional Modifier None Typical Low $138.04 Median $257.04 Typical High $257.04 | Professional | None | $138.04 | $257.04 | $257.04 |
5 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 $89.13 Median $120.23 Typical High $162.18 | Professional | 52 · Reduced service | $89.13 | $120.23 | $162.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $47.86 Typical High $64.57 | Professional | 53 · Discontinued | $35.48 | $47.86 | $64.57 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $131.83 Median $177.83 Typical High $239.88 | Professional | 54 · Surgery only | $131.83 | $177.83 | $239.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $36.31 Typical High $48.98 | Professional | 55 · Aftercare only | $26.92 | $36.31 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $23.99 Typical High $32.36 | Professional | 56 · Pre-op care only | $17.78 | $23.99 | $32.36 |
Where Florida sits
The same service costs 7.9 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 $5,867MT $745
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.