How much rates vary
Facilitymedian $2,692 · 10th to 90th $437 to $24,547Professionalmedian $2,239 · 10th to 90th $309 to $4,365
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 $2,238.72 Median $2,570.40 Typical High $3,162.28 | Professional | None | $2,238.72 | $2,570.40 | $3,162.28 |
Ambetter Setting Professional Modifier None Typical Low $4,786.30 Median $4,786.30 Typical High $5,754.40 | Professional | None | $4,786.30 | $4,786.30 | $5,754.40 |
AvMed Setting Facility Modifier None Typical Low $1,445.44 Median $2,691.53 Typical High $11,748.98 | Facility | None | $1,445.44 | $2,691.53 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $2,344.23 Median $2,884.03 Typical High $3,388.44 | Professional | None | $2,344.23 | $2,884.03 | $3,388.44 |
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 $1,949.84 Median $2,754.23 Typical High $5,495.41 | Professional | None | $1,949.84 | $2,754.23 | $5,495.41 |
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 $1,905.46 Median $2,041.74 Typical High $2,818.38 | Professional | None | $1,905.46 | $2,041.74 | $2,818.38 |
Molina Setting Professional Modifier None Typical Low $295.12 Median $1,995.26 Typical High $4,073.80 | Professional | None | $295.12 | $1,995.26 | $4,073.80 |
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 $3,019.95 Typical High $5,888.44 | Professional | None | $60.26 | $3,019.95 | $5,888.44 |
Wellpoint Setting Professional Modifier None Typical Low $1,949.84 Median $1,949.84 Typical High $2,691.53 | Professional | None | $1,949.84 | $1,949.84 | $2,691.53 |
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 $1,122.02 Median $1,230.27 Typical High $1,479.11 | Professional | 52 · Reduced service | $1,122.02 | $1,230.27 | $1,479.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $446.68 Median $489.78 Typical High $588.84 | Professional | 53 · Discontinued | $446.68 | $489.78 | $588.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,698.24 Median $1,862.09 Typical High $2,187.76 | Professional | 54 · Surgery only | $1,698.24 | $1,862.09 | $2,187.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $338.84 Median $371.54 Typical High $436.52 | Professional | 55 · Aftercare only | $338.84 | $371.54 | $436.52 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $223.87 Median $245.47 Typical High $295.12 | Professional | 56 · Pre-op care only | $223.87 | $245.47 | $295.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,584.89 Median $1,737.80 Typical High $2,041.74 | Professional | 78 · Unplanned return to OR | $1,584.89 | $1,737.80 | $2,041.74 |
Where Florida sits
The same service costs 12.3 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 $35,907WA $2,929
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.