How much rates vary
Facilitymedian $3,020 · 10th to 90th $501 to $24,547Professionalmedian $933 · 10th to 90th $110 to $1,820
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 $954.99 Median $3,801.89 Typical High $12,022.64 | Facility | None | $954.99 | $3,801.89 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $977.24 Median $1,000.00 Typical High $2,041.74 | Professional | None | $977.24 | $1,000.00 | $2,041.74 |
Ambetter Setting Professional Modifier None Typical Low $977.24 Median $977.24 Typical High $1,584.89 | Professional | None | $977.24 | $977.24 | $1,584.89 |
AvMed Setting Facility Modifier None Typical Low $851.14 Median $2,137.96 Typical High $11,748.98 | Facility | None | $851.14 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $891.25 Median $1,174.90 Typical High $1,348.96 | Professional | None | $891.25 | $1,174.90 | $1,348.96 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $501.19 Typical High $2,691.53 | Facility | None | $398.11 | $501.19 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $851.14 Median $1,148.15 Typical High $2,238.72 | Professional | None | $851.14 | $1,148.15 | $2,238.72 |
Florida Blue Setting Facility Modifier None Typical Low $10,471.29 Median $22,387.21 Typical High $33,884.42 | Facility | None | $10,471.29 | $22,387.21 | $33,884.42 |
Florida Blue Setting Professional Modifier None Typical Low $741.31 Median $794.33 Typical High $1,202.26 | Professional | None | $741.31 | $794.33 | $1,202.26 |
Molina Setting Professional Modifier None Typical Low $104.71 Median $794.33 Typical High $1,659.59 | Professional | None | $104.71 | $794.33 | $1,659.59 |
United Setting Facility Modifier None Typical Low $954.99 Median $2,344.23 Typical High $10,232.93 | Facility | None | $954.99 | $2,344.23 | $10,232.93 |
United Setting Professional Modifier None Typical Low $60.26 Median $1,288.25 Typical High $2,454.71 | Professional | None | $60.26 | $1,288.25 | $2,454.71 |
Wellpoint Setting Professional Modifier None Typical Low $794.33 Median $794.33 Typical High $1,071.52 | Professional | None | $794.33 | $794.33 | $1,071.52 |
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 $489.78 Median $501.19 Typical High $630.96 | Professional | 52 · Reduced service | $489.78 | $501.19 | $630.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $194.98 Median $199.53 Typical High $251.19 | Professional | 53 · Discontinued | $194.98 | $199.53 | $251.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $758.58 Typical High $933.25 | Professional | 54 · Surgery only | $741.31 | $758.58 | $933.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $151.36 Typical High $186.21 | Professional | 55 · Aftercare only | $147.91 | $151.36 | $186.21 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $100.00 Typical High $125.89 | Professional | 56 · Pre-op care only | $97.72 | $100.00 | $125.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $691.83 Median $707.95 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $691.83 | $707.95 | $870.96 |
Where Florida sits
The same service costs 9.2 times more in Maine than in Texas. 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
ME $22,965TX $2,508
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.