How much rates vary
Facilitymedian $3,388 · 10th to 90th $1,380 to $14,125Professionalmedian $603 · 10th to 90th $79 to $1,175
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 $707.95 Median $4,897.79 Typical High $12,302.69 | Facility | None | $707.95 | $4,897.79 | $12,302.69 |
Aetna Setting Professional Modifier None Typical Low $602.56 Median $630.96 Typical High $1,380.38 | Professional | None | $602.56 | $630.96 | $1,380.38 |
Ambetter Setting Professional Modifier None Typical Low $309.03 Median $630.96 Typical High $933.25 | Professional | None | $309.03 | $630.96 | $933.25 |
AvMed Setting Facility Modifier None Typical Low $616.60 Median $2,137.96 Typical High $9,772.37 | Facility | None | $616.60 | $2,137.96 | $9,772.37 |
AvMed Setting Professional Modifier None Typical Low $575.44 Median $758.58 Typical High $831.76 | Professional | None | $575.44 | $758.58 | $831.76 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $3,467.37 Typical High $11,481.54 | Facility | None | $707.95 | $3,467.37 | $11,481.54 |
Cigna Setting Professional Modifier None Typical Low $537.03 Median $741.31 Typical High $1,412.54 | Professional | None | $537.03 | $741.31 | $1,412.54 |
Florida Blue Setting Facility Modifier None Typical Low $1,737.80 Median $3,548.13 Typical High $16,982.44 | Facility | None | $1,737.80 | $3,548.13 | $16,982.44 |
Florida Blue Setting Professional Modifier None Typical Low $478.63 Median $512.86 Typical High $851.14 | Professional | None | $478.63 | $512.86 | $851.14 |
Molina Setting Professional Modifier None Typical Low $72.44 Median $512.86 Typical High $1,096.48 | Professional | None | $72.44 | $512.86 | $1,096.48 |
United Setting Facility Modifier None Typical Low $1,348.96 Median $3,981.07 Typical High $15,135.61 | Facility | None | $1,348.96 | $3,981.07 | $15,135.61 |
United Setting Professional Modifier None Typical Low $60.26 Median $812.83 Typical High $1,513.56 | Professional | None | $60.26 | $812.83 | $1,513.56 |
Wellpoint Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $691.83 | Professional | None | $512.86 | $512.86 | $691.83 |
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 $302.00 Median $309.03 Typical High $398.11 | Professional | 52 · Reduced service | $302.00 | $309.03 | $398.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $123.03 Typical High $158.49 | Professional | 53 · Discontinued | $120.23 | $123.03 | $158.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $467.74 Typical High $588.84 | Professional | 54 · Surgery only | $457.09 | $467.74 | $588.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $93.33 Typical High $120.23 | Professional | 55 · Aftercare only | $91.20 | $93.33 | $120.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $61.66 Typical High $79.43 | Professional | 56 · Pre-op care only | $60.26 | $61.66 | $79.43 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $436.52 Typical High $549.54 | Professional | 78 · Unplanned return to OR | $426.58 | $436.52 | $549.54 |
Where Florida sits
The same service costs 4.5 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 $10,099MT $2,245
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.