How much rates vary
Facilitymedian $2,692 · 10th to 90th $437 to $24,547Professionalmedian $2,692 · 10th to 90th $407 to $5,012
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 $2,570.40 Median $2,818.38 Typical High $3,388.44 | Professional | None | $2,570.40 | $2,818.38 | $3,388.44 |
Ambetter Setting Professional Modifier None Typical Low $2,041.74 Median $2,041.74 Typical High $6,025.60 | Professional | None | $2,041.74 | $2,041.74 | $6,025.60 |
AvMed Setting Facility Modifier None Typical Low $1,445.44 Median $2,818.38 Typical High $11,748.98 | Facility | None | $1,445.44 | $2,818.38 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $2,511.89 Median $3,090.30 Typical High $3,715.35 | Professional | None | $2,511.89 | $3,090.30 | $3,715.35 |
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 $2,187.76 Median $3,019.95 Typical High $6,165.95 | Professional | None | $2,187.76 | $3,019.95 | $6,165.95 |
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 $2,041.74 Median $2,187.76 Typical High $3,162.28 | Professional | None | $2,041.74 | $2,187.76 | $3,162.28 |
Molina Setting Professional Modifier None Typical Low $371.54 Median $2,454.71 Typical High $4,897.79 | Professional | None | $371.54 | $2,454.71 | $4,897.79 |
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 $3,388.44 Typical High $6,606.93 | Professional | None | $60.26 | $3,388.44 | $6,606.93 |
Wellpoint Setting Professional Modifier None Typical Low $2,137.96 Median $2,137.96 Typical High $2,951.21 | Professional | None | $2,137.96 | $2,137.96 | $2,951.21 |
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 $1,258.93 Median $1,412.54 Typical High $1,659.59 | Professional | 52 · Reduced service | $1,258.93 | $1,412.54 | $1,659.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $512.86 Median $562.34 Typical High $660.69 | Professional | 53 · Discontinued | $512.86 | $562.34 | $660.69 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,905.46 Median $2,089.30 Typical High $2,454.71 | Professional | 54 · Surgery only | $1,905.46 | $2,089.30 | $2,454.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $380.19 Median $416.87 Typical High $501.19 | Professional | 55 · Aftercare only | $380.19 | $416.87 | $501.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $257.04 Median $281.84 Typical High $331.13 | Professional | 56 · Pre-op care only | $257.04 | $281.84 | $331.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,778.28 Median $1,949.84 Typical High $2,290.87 | Professional | 78 · Unplanned return to OR | $1,778.28 | $1,949.84 | $2,290.87 |
Where Florida sits
The same service costs 9.8 times more in Maine than in Maryland. 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 $36,528MD $3,725
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.