How much rates vary
Facilitymedian $2,042 · 10th to 90th $871 to $12,023Professionalmedian $309 · 10th to 90th $195 to $589
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 $575.44 Median $4,365.16 Typical High $11,748.98 | Facility | None | $575.44 | $4,365.16 | $11,748.98 |
Aetna Setting Professional Modifier None Typical Low $281.84 Median $295.12 Typical High $489.78 | Professional | None | $281.84 | $295.12 | $489.78 |
Ambetter Setting Professional Modifier None Typical Low $177.83 Median $234.42 Typical High $616.60 | Professional | None | $177.83 | $234.42 | $616.60 |
AvMed Setting Facility Modifier None Typical Low $501.19 Median $2,089.30 Typical High $9,772.37 | Facility | None | $501.19 | $2,089.30 | $9,772.37 |
AvMed Setting Professional Modifier None Typical Low $263.03 Median $338.84 Typical High $371.54 | Professional | None | $263.03 | $338.84 | $371.54 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $1,995.26 Typical High $3,019.95 | Facility | None | $501.19 | $1,995.26 | $3,019.95 |
Cigna Setting Professional Modifier None Typical Low $234.42 Median $331.13 Typical High $630.96 | Professional | None | $234.42 | $331.13 | $630.96 |
Florida Blue Setting Facility Modifier None Typical Low $977.24 Median $1,949.84 Typical High $16,982.44 | Facility | None | $977.24 | $1,949.84 | $16,982.44 |
Florida Blue Setting Professional Modifier None Typical Low $218.78 Median $234.42 Typical High $380.19 | Professional | None | $218.78 | $234.42 | $380.19 |
Molina Setting Professional Modifier None Typical Low $42.66 Median $309.03 Typical High $602.56 | Professional | None | $42.66 | $309.03 | $602.56 |
United Setting Facility Modifier None Typical Low $954.99 Median $2,290.87 Typical High $10,000.00 | Facility | None | $954.99 | $2,290.87 | $10,000.00 |
United Setting Professional Modifier None Typical Low $60.26 Median $363.08 Typical High $676.08 | Professional | None | $60.26 | $363.08 | $676.08 |
Wellpoint Setting Professional Modifier None Typical Low $239.88 Median $239.88 Typical High $316.23 | Professional | None | $239.88 | $239.88 | $316.23 |
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 $141.25 Median $144.54 Typical High $194.98 | Professional | 52 · Reduced service | $141.25 | $144.54 | $194.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $57.54 Typical High $77.62 | Professional | 53 · Discontinued | $56.23 | $57.54 | $77.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $213.80 Median $213.80 Typical High $288.40 | Professional | 54 · Surgery only | $213.80 | $213.80 | $288.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $42.66 Median $42.66 Typical High $57.54 | Professional | 55 · Aftercare only | $42.66 | $42.66 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $28.84 Typical High $38.90 | Professional | 56 · Pre-op care only | $28.18 | $28.84 | $38.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $199.53 Median $199.53 Typical High $269.15 | Professional | 78 · Unplanned return to OR | $199.53 | $199.53 | $269.15 |
Where Florida sits
The same service costs 5.3 times more in Alaska 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
AK $5,518MT $1,050
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.