How much rates vary
Facilitymedian $1,905 · 10th to 90th $759 to $7,413Professionalmedian $309 · 10th to 90th $204 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 $660.69 Median $5,495.41 Typical High $12,022.64 | Facility | None | $660.69 | $5,495.41 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $281.84 Median $288.40 Typical High $478.63 | Professional | None | $281.84 | $288.40 | $478.63 |
Ambetter Setting Professional Modifier None Typical Low $288.40 Median $288.40 Typical High $288.40 | Professional | None | $288.40 | $288.40 | $288.40 |
AvMed Setting Facility Modifier None Typical Low $501.19 Median $2,137.96 Typical High $9,772.37 | Facility | None | $501.19 | $2,137.96 | $9,772.37 |
AvMed Setting Professional Modifier None Typical Low $257.04 Median $331.13 Typical High $363.08 | Professional | None | $257.04 | $331.13 | $363.08 |
Cigna Setting Facility Modifier None Typical Low $616.60 Median $1,174.90 Typical High $3,311.31 | Facility | None | $616.60 | $1,174.90 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $229.09 Median $323.59 Typical High $616.60 | Professional | None | $229.09 | $323.59 | $616.60 |
Florida Blue Setting Facility Modifier None Typical Low $912.01 Median $1,995.26 Typical High $7,413.10 | Facility | None | $912.01 | $1,995.26 | $7,413.10 |
Florida Blue Setting Professional Modifier None Typical Low $213.80 Median $229.09 Typical High $371.54 | Professional | None | $213.80 | $229.09 | $371.54 |
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 $794.33 Median $1,698.24 Typical High $7,585.78 | Facility | None | $794.33 | $1,698.24 | $7,585.78 |
United Setting Professional Modifier None Typical Low $60.26 Median $354.81 Typical High $676.08 | Professional | None | $60.26 | $354.81 | $676.08 |
Wellpoint Setting Professional Modifier None Typical Low $234.42 Median $234.42 Typical High $302.00 | Professional | None | $234.42 | $234.42 | $302.00 |
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 $138.04 Median $141.25 Typical High $190.55 | Professional | 52 · Reduced service | $138.04 | $141.25 | $190.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $56.23 Typical High $75.86 | Professional | 53 · Discontinued | $56.23 | $56.23 | $75.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $208.93 Typical High $281.84 | Professional | 54 · Surgery only | $208.93 | $208.93 | $281.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $41.69 Typical High $56.23 | Professional | 55 · Aftercare only | $41.69 | $41.69 | $56.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $28.18 Typical High $38.02 | Professional | 56 · Pre-op care only | $28.18 | $28.18 | $38.02 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $194.98 Median $194.98 Typical High $263.03 | Professional | 78 · Unplanned return to OR | $194.98 | $194.98 | $263.03 |
Where Florida sits
The same service costs 5.1 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 $5,094MT $991
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.