How much rates vary
Facilitymedian $3,311 · 10th to 90th $501 to $23,988Professionalmedian $692 · 10th to 90th $112 to $1,318
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 $758.58 Median $6,025.60 Typical High $12,882.50 | Facility | None | $758.58 | $6,025.60 | $12,882.50 |
Aetna Setting Professional Modifier None Typical Low $660.69 Median $691.83 Typical High $1,202.26 | Professional | None | $660.69 | $691.83 | $1,202.26 |
Ambetter Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $758.58 | Professional | None | $758.58 | $758.58 | $758.58 |
AvMed Setting Facility Modifier None Typical Low $630.96 Median $2,137.96 Typical High $11,748.98 | Facility | None | $630.96 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $645.65 Median $794.33 Typical High $933.25 | Professional | None | $645.65 | $794.33 | $933.25 |
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 $588.84 Median $794.33 Typical High $1,548.82 | Professional | None | $588.84 | $794.33 | $1,548.82 |
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 $457.09 Median $537.03 Typical High $794.33 | Professional | None | $457.09 | $537.03 | $794.33 |
Molina Setting Professional Modifier None Typical Low $104.71 Median $645.65 Typical High $1,288.25 | Professional | None | $104.71 | $645.65 | $1,288.25 |
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 $870.96 Typical High $1,659.59 | Professional | None | $60.26 | $870.96 | $1,659.59 |
Wellpoint Setting Professional Modifier None Typical Low $562.34 Median $562.34 Typical High $758.58 | Professional | None | $562.34 | $562.34 | $758.58 |
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 $323.59 Median $346.74 Typical High $426.58 | Professional | 52 · Reduced service | $323.59 | $346.74 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $138.04 Typical High $169.82 | Professional | 53 · Discontinued | $131.83 | $138.04 | $169.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $512.86 Typical High $645.65 | Professional | 54 · Surgery only | $489.78 | $512.86 | $645.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $102.33 Typical High $128.82 | Professional | 55 · Aftercare only | $97.72 | $102.33 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $69.18 Typical High $85.11 | Professional | 56 · Pre-op care only | $66.07 | $69.18 | $85.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $457.09 Median $478.63 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $457.09 | $478.63 | $602.56 |
Where Florida sits
The same service costs 11.6 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 $23,484TX $2,029
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.