How much rates vary
Facilitymedian $2,512 · 10th to 90th $891 to $12,023Professionalmedian $692 · 10th to 90th $78 to $1,349
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 $660.69 Median $3,311.31 Typical High $11,481.54 | Facility | None | $660.69 | $3,311.31 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $676.08 Median $724.44 Typical High $933.25 | Professional | None | $676.08 | $724.44 | $933.25 |
AvMed Setting Facility Modifier None Typical Low $501.19 Median $1,513.56 Typical High $9,549.93 | Facility | None | $501.19 | $1,513.56 | $9,549.93 |
AvMed Setting Professional Modifier None Typical Low $616.60 Median $794.33 Typical High $870.96 | Professional | None | $616.60 | $794.33 | $870.96 |
Cigna Setting Facility Modifier None Typical Low $323.59 Median $2,630.27 Typical High $4,786.30 | Facility | None | $323.59 | $2,630.27 | $4,786.30 |
Cigna Setting Professional Modifier None Typical Low $562.34 Median $776.25 Typical High $1,513.56 | Professional | None | $562.34 | $776.25 | $1,513.56 |
Florida Blue Setting Facility Modifier None Typical Low $1,318.26 Median $2,630.27 Typical High $16,982.44 | Facility | None | $1,318.26 | $2,630.27 | $16,982.44 |
Florida Blue Setting Professional Modifier None Typical Low $512.86 Median $549.54 Typical High $812.83 | Professional | None | $512.86 | $549.54 | $812.83 |
Molina Setting Professional Modifier None Typical Low $69.18 Median $660.69 Typical High $1,348.96 | Professional | None | $69.18 | $660.69 | $1,348.96 |
United Setting Facility Modifier None Typical Low $954.99 Median $2,344.23 Typical High $10,000.00 | Facility | None | $954.99 | $2,344.23 | $10,000.00 |
United Setting Professional Modifier None Typical Low $60.26 Median $870.96 Typical High $1,621.81 | Professional | None | $60.26 | $870.96 | $1,621.81 |
Wellpoint Setting Professional Modifier None Typical Low $562.34 Median $562.34 Typical High $741.31 | Professional | None | $562.34 | $562.34 | $741.31 |
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 $338.84 Median $363.08 Typical High $457.09 | Professional | 52 · Reduced service | $338.84 | $363.08 | $457.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $144.54 Typical High $181.97 | Professional | 53 · Discontinued | $134.90 | $144.54 | $181.97 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $537.03 Typical High $691.83 | Professional | 54 · Surgery only | $512.86 | $537.03 | $691.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $109.65 Typical High $138.04 | Professional | 55 · Aftercare only | $102.33 | $109.65 | $138.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $72.44 Typical High $91.20 | Professional | 56 · Pre-op care only | $67.61 | $72.44 | $91.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $501.19 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $478.63 | $501.19 | $645.65 |
Where Florida sits
The same service costs 5.0 times more in Oklahoma than in Hawaii. 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 $9,757HI $1,932
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.