How much rates vary
Facilitymedian $1,905 · 10th to 90th $776 to $11,749Professionalmedian $490 · 10th to 90th $78 to $955
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 $645.65 Median $4,786.30 Typical High $12,882.50 | Facility | None | $645.65 | $4,786.30 | $12,882.50 |
Aetna Setting Professional Modifier None Typical Low $416.87 Median $467.74 Typical High $1,047.13 | Professional | None | $416.87 | $467.74 | $1,047.13 |
Ambetter Setting Professional Modifier None Typical Low $575.44 Median $575.44 Typical High $758.58 | Professional | None | $575.44 | $575.44 | $758.58 |
AvMed Setting Facility Modifier None Typical Low $562.34 Median $1,949.84 Typical High $9,772.37 | Facility | None | $562.34 | $1,949.84 | $9,772.37 |
AvMed Setting Professional Modifier None Typical Low $467.74 Median $562.34 Typical High $630.96 | Professional | None | $467.74 | $562.34 | $630.96 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $2,041.74 Typical High $3,801.89 | Facility | None | $707.95 | $2,041.74 | $3,801.89 |
Cigna Setting Professional Modifier None Typical Low $416.87 Median $562.34 Typical High $1,047.13 | Professional | None | $416.87 | $562.34 | $1,047.13 |
Florida Blue Setting Facility Modifier None Typical Low $891.25 Median $1,737.80 Typical High $16,982.44 | Facility | None | $891.25 | $1,737.80 | $16,982.44 |
Florida Blue Setting Professional Modifier None Typical Low $371.54 Median $416.87 Typical High $537.03 | Professional | None | $371.54 | $416.87 | $537.03 |
Molina Setting Professional Modifier None Typical Low $69.18 Median $467.74 Typical High $933.25 | Professional | None | $69.18 | $467.74 | $933.25 |
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 $60.26 Median $602.56 Typical High $1,174.90 | Professional | None | $60.26 | $602.56 | $1,174.90 |
Wellpoint Setting Professional Modifier None Typical Low $426.58 Median $426.58 Typical High $562.34 | Professional | None | $426.58 | $426.58 | $562.34 |
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 $208.93 Median $229.09 Typical High $302.00 | Professional | 52 · Reduced service | $208.93 | $229.09 | $302.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $93.33 Typical High $120.23 | Professional | 53 · Discontinued | $83.18 | $93.33 | $120.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $346.74 Typical High $457.09 | Professional | 54 · Surgery only | $309.03 | $346.74 | $457.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $69.18 Typical High $91.20 | Professional | 55 · Aftercare only | $61.66 | $69.18 | $91.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $45.71 Typical High $60.26 | Professional | 56 · Pre-op care only | $41.69 | $45.71 | $60.26 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $323.59 Typical High $426.58 | Professional | 78 · Unplanned return to OR | $288.40 | $323.59 | $426.58 |
Where Florida sits
The same service costs 3.6 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 $6,446MT $1,806
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.