How much rates vary
Facilitymedian $2,512 · 10th to 90th $437 to $24,547Professionalmedian $1,778 · 10th to 90th $234 to $3,388
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 $1,698.24 Median $1,905.46 Typical High $2,511.89 | Professional | None | $1,698.24 | $1,905.46 | $2,511.89 |
Ambetter Setting Professional Modifier None Typical Low $2,754.23 Median $2,884.03 Typical High $2,884.03 | Professional | None | $2,754.23 | $2,884.03 | $2,884.03 |
AvMed Setting Facility Modifier None Typical Low $1,445.44 Median $2,290.87 Typical High $11,748.98 | Facility | None | $1,445.44 | $2,290.87 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $1,819.70 Median $2,187.76 Typical High $2,570.40 | Professional | None | $1,819.70 | $2,187.76 | $2,570.40 |
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 $1,513.56 Median $2,041.74 Typical High $4,168.69 | Professional | None | $1,513.56 | $2,041.74 | $4,168.69 |
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 $1,479.11 Median $1,584.89 Typical High $2,137.96 | Professional | None | $1,479.11 | $1,584.89 | $2,137.96 |
Molina Setting Professional Modifier None Typical Low $223.87 Median $1,584.89 Typical High $3,235.94 | Professional | None | $223.87 | $1,584.89 | $3,235.94 |
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 $2,290.87 Typical High $4,466.84 | Professional | None | $60.26 | $2,290.87 | $4,466.84 |
Wellpoint Setting Professional Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $2,089.30 | Professional | None | $1,513.56 | $1,513.56 | $2,089.30 |
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 $851.14 Median $954.99 Typical High $1,122.02 | Professional | 52 · Reduced service | $851.14 | $954.99 | $1,122.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $338.84 Median $380.19 Typical High $446.68 | Professional | 53 · Discontinued | $338.84 | $380.19 | $446.68 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,258.93 Median $1,445.44 Typical High $1,659.59 | Professional | 54 · Surgery only | $1,258.93 | $1,445.44 | $1,659.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $251.19 Median $288.40 Typical High $331.13 | Professional | 55 · Aftercare only | $251.19 | $288.40 | $331.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $169.82 Median $190.55 Typical High $223.87 | Professional | 56 · Pre-op care only | $169.82 | $190.55 | $223.87 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,174.90 Median $1,348.96 Typical High $1,548.82 | Professional | 78 · Unplanned return to OR | $1,174.90 | $1,348.96 | $1,548.82 |
Where Florida sits
The same service costs 13.8 times more in Maine than in Washington. 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 $35,114WA $2,549
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.