How much rates vary
Facilitymedian $1,950 · 10th to 90th $794 to $12,023Professionalmedian $589 · 10th to 90th $81 to $1,148
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 $602.56 Median $3,890.45 Typical High $11,481.54 | Facility | None | $602.56 | $3,890.45 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $588.84 Median $602.56 Typical High $831.76 | Professional | None | $588.84 | $602.56 | $831.76 |
AvMed Setting Facility Modifier None Typical Low $524.81 Median $2,137.96 Typical High $11,748.98 | Facility | None | $524.81 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $512.86 Median $630.96 Typical High $741.31 | Professional | None | $512.86 | $630.96 | $741.31 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $2,041.74 Typical High $5,248.07 | Facility | None | $501.19 | $2,041.74 | $5,248.07 |
Cigna Setting Professional Modifier None Typical Low $478.63 Median $676.08 Typical High $1,288.25 | Professional | None | $478.63 | $676.08 | $1,288.25 |
Florida Blue Setting Facility Modifier None Typical Low $891.25 Median $1,778.28 Typical High $16,982.44 | Facility | None | $891.25 | $1,778.28 | $16,982.44 |
Florida Blue Setting Professional Modifier None Typical Low $446.68 Median $478.63 Typical High $741.31 | Professional | None | $446.68 | $478.63 | $741.31 |
Molina Setting Professional Modifier None Typical Low $69.18 Median $549.54 Typical High $1,122.02 | Professional | None | $69.18 | $549.54 | $1,122.02 |
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 $549.54 Median $812.83 Typical High $1,445.44 | Professional | None | $549.54 | $812.83 | $1,445.44 |
Wellpoint Setting Professional Modifier None Typical Low $478.63 Median $478.63 Typical High $630.96 | Professional | None | $478.63 | $478.63 | $630.96 |
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 $295.12 Median $302.00 Typical High $389.05 | Professional | 52 · Reduced service | $295.12 | $302.00 | $389.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $120.23 Typical High $154.88 | Professional | 53 · Discontinued | $120.23 | $120.23 | $154.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $446.68 Median $446.68 Typical High $588.84 | Professional | 54 · Surgery only | $446.68 | $446.68 | $588.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $91.20 Typical High $117.49 | Professional | 55 · Aftercare only | $89.13 | $91.20 | $117.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $58.88 Median $60.26 Typical High $77.62 | Professional | 56 · Pre-op care only | $58.88 | $60.26 | $77.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $416.87 Median $416.87 Typical High $549.54 | Professional | 78 · Unplanned return to OR | $416.87 | $416.87 | $549.54 |
Ambetter Setting Professional Modifier 51 · Multiple procedures Typical Low $933.25 Median $933.25 Typical High $933.25 | Professional | 51 · Multiple procedures | $933.25 | $933.25 | $933.25 |
Where Florida sits
The same service costs 4.2 times more in Oklahoma than in Kentucky. 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 $7,369KY $1,773
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.