How much rates vary
Facilitymedian $2,399 · 10th to 90th $437 to $24,547Professionalmedian $813 · 10th to 90th $123 to $1,585
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 $776.25 Median $3,890.45 Typical High $12,022.64 | Facility | None | $776.25 | $3,890.45 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $741.31 Median $870.96 Typical High $1,071.52 | Professional | None | $741.31 | $870.96 | $1,071.52 |
AvMed Setting Facility Modifier None Typical Low $794.33 Median $2,137.96 Typical High $11,748.98 | Facility | None | $794.33 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $812.83 Median $977.24 Typical High $1,174.90 | Professional | None | $812.83 | $977.24 | $1,174.90 |
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 $691.83 Median $954.99 Typical High $1,862.09 | Professional | None | $691.83 | $954.99 | $1,862.09 |
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 $676.08 Median $741.31 Typical High $954.99 | Professional | None | $676.08 | $741.31 | $954.99 |
Molina Setting Professional Modifier None Typical Low $117.49 Median $724.44 Typical High $1,513.56 | Professional | None | $117.49 | $724.44 | $1,513.56 |
United Setting Facility Modifier None Typical Low $371.54 Median $954.99 Typical High $7,585.78 | Facility | None | $371.54 | $954.99 | $7,585.78 |
United Setting Professional Modifier None Typical Low $60.26 Median $1,023.29 Typical High $1,995.26 | Professional | None | $60.26 | $1,023.29 | $1,995.26 |
Wellpoint Setting Professional Modifier None Typical Low $724.44 Median $724.44 Typical High $977.24 | Professional | None | $724.44 | $724.44 | $977.24 |
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 $371.54 Median $436.52 Typical High $501.19 | Professional | 52 · Reduced service | $371.54 | $436.52 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $173.78 Typical High $204.17 | Professional | 53 · Discontinued | $147.91 | $173.78 | $204.17 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $645.65 Typical High $758.58 | Professional | 54 · Surgery only | $562.34 | $645.65 | $758.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $128.82 Typical High $151.36 | Professional | 55 · Aftercare only | $112.20 | $128.82 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $87.10 Typical High $100.00 | Professional | 56 · Pre-op care only | $74.13 | $87.10 | $100.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $602.56 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $524.81 | $602.56 | $707.95 |
Where Florida sits
The same service costs 10.1 times more in Maine than in Arkansas. 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 $16,050AR $1,584
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.