How much rates vary
Facilitymedian $234 · 10th to 90th $72 to $3,388Professionalmedian $186 · 10th to 90th $110 to $363
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 $190.55 Median $2,818.38 Typical High $10,964.78 | Facility | None | $190.55 | $2,818.38 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $117.49 Median $177.83 Typical High $288.40 | Professional | None | $117.49 | $177.83 | $288.40 |
Ambetter Setting Professional Modifier None Typical Low $173.78 Median $436.52 Typical High $436.52 | Professional | None | $173.78 | $436.52 | $436.52 |
AvMed Setting Facility Modifier None Typical Low $134.90 Median $954.99 Typical High $9,549.93 | Facility | None | $134.90 | $954.99 | $9,549.93 |
AvMed Setting Professional Modifier None Typical Low $138.04 Median $213.80 Typical High $263.03 | Professional | None | $138.04 | $213.80 | $263.03 |
Cigna Setting Facility Modifier None Typical Low $134.90 Median $281.84 Typical High $1,659.59 | Facility | None | $134.90 | $281.84 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $100.00 Median $169.82 Typical High $346.74 | Professional | None | $100.00 | $169.82 | $346.74 |
Florida Blue Setting Facility Modifier None Typical Low $64.57 Median $131.83 Typical High $3,019.95 | Facility | None | $64.57 | $131.83 | $3,019.95 |
Florida Blue Setting Professional Modifier None Typical Low $154.88 Median $177.83 Typical High $239.88 | Professional | None | $154.88 | $177.83 | $239.88 |
Molina Setting Professional Modifier None Typical Low $173.78 Median $245.47 Typical High $489.78 | Professional | None | $173.78 | $245.47 | $489.78 |
United Setting Facility Modifier None Typical Low $81.28 Median $302.00 Typical High $2,818.38 | Facility | None | $81.28 | $302.00 | $2,818.38 |
United Setting Professional Modifier None Typical Low $107.15 Median $199.53 Typical High $380.19 | Professional | None | $107.15 | $199.53 | $380.19 |
Wellpoint Setting Professional Modifier None Typical Low $100.00 Median $186.21 Typical High $186.21 | Professional | None | $100.00 | $186.21 | $186.21 |
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 $58.88 Median $85.11 Typical High $107.15 | Professional | 52 · Reduced service | $58.88 | $85.11 | $107.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $33.88 Typical High $42.66 | Professional | 53 · Discontinued | $23.44 | $33.88 | $42.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $89.13 Median $125.89 Typical High $162.18 | Professional | 54 · Surgery only | $89.13 | $125.89 | $162.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $25.12 Typical High $32.36 | Professional | 55 · Aftercare only | $17.78 | $25.12 | $32.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $16.98 Typical High $21.38 | Professional | 56 · Pre-op care only | $11.75 | $16.98 | $21.38 |
Where Florida sits
The same service costs 8.8 times more in New York than in Alabama. 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
NY $2,761AL $314
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.