How much rates vary
Facilitymedian $2,692 · 10th to 90th $437 to $24,547Professionalmedian $3,890 · 10th to 90th $537 to $7,586
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 $4,466.84 Typical High $12,022.64 | Facility | None | $776.25 | $4,466.84 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $3,890.45 Median $4,466.84 Typical High $5,370.32 | Professional | None | $3,890.45 | $4,466.84 | $5,370.32 |
Ambetter Setting Professional Modifier None Typical Low $8,128.31 Median $8,128.31 Typical High $8,128.31 | Professional | None | $8,128.31 | $8,128.31 | $8,128.31 |
AvMed Setting Facility Modifier None Typical Low $1,445.44 Median $4,466.84 Typical High $11,748.98 | Facility | None | $1,445.44 | $4,466.84 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $3,981.07 Median $5,011.87 Typical High $5,888.44 | Professional | None | $3,981.07 | $5,011.87 | $5,888.44 |
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 $3,467.37 Median $4,786.30 Typical High $9,549.93 | Professional | None | $3,467.37 | $4,786.30 | $9,549.93 |
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 $3,235.94 Median $3,548.13 Typical High $4,897.79 | Professional | None | $3,235.94 | $3,548.13 | $4,897.79 |
Molina Setting Professional Modifier None Typical Low $501.19 Median $3,388.44 Typical High $7,079.46 | Professional | None | $501.19 | $3,388.44 | $7,079.46 |
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 $5,370.32 Typical High $10,232.93 | Professional | None | $60.26 | $5,370.32 | $10,232.93 |
Wellpoint Setting Professional Modifier None Typical Low $3,311.31 Median $3,311.31 Typical High $4,677.35 | Professional | None | $3,311.31 | $3,311.31 | $4,677.35 |
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 $1,949.84 Median $2,137.96 Typical High $2,511.89 | Professional | 52 · Reduced service | $1,949.84 | $2,137.96 | $2,511.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $776.25 Median $851.14 Typical High $1,000.00 | Professional | 53 · Discontinued | $776.25 | $851.14 | $1,000.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,951.21 Median $3,235.94 Typical High $3,801.89 | Professional | 54 · Surgery only | $2,951.21 | $3,235.94 | $3,801.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $588.84 Median $645.65 Typical High $758.58 | Professional | 55 · Aftercare only | $588.84 | $645.65 | $758.58 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $389.05 Median $426.58 Typical High $501.19 | Professional | 56 · Pre-op care only | $389.05 | $426.58 | $501.19 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,754.23 Median $3,019.95 Typical High $3,548.13 | Professional | 78 · Unplanned return to OR | $2,754.23 | $3,019.95 | $3,548.13 |
Where Florida sits
The same service costs 8.7 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 $38,525WA $4,436
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.