How much rates vary
Facilitymedian $2,291 · 10th to 90th $437 to $24,547Professionalmedian $1,349 · 10th to 90th $191 to $2,630
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 $3,801.89 Typical High $12,022.64 | Facility | None | $776.25 | $3,801.89 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $1,348.96 Median $1,513.56 Typical High $1,819.70 | Professional | None | $1,348.96 | $1,513.56 | $1,819.70 |
AvMed Setting Facility Modifier None Typical Low $1,318.26 Median $2,137.96 Typical High $11,748.98 | Facility | None | $1,318.26 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $1,412.54 Median $1,698.24 Typical High $2,041.74 | Professional | None | $1,412.54 | $1,698.24 | $2,041.74 |
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 $1,202.26 Median $1,659.59 Typical High $3,311.31 | Professional | None | $1,202.26 | $1,659.59 | $3,311.31 |
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 $1,174.90 Median $1,258.93 Typical High $1,698.24 | Professional | None | $1,174.90 | $1,258.93 | $1,698.24 |
Molina Setting Professional Modifier None Typical Low $177.83 Median $1,202.26 Typical High $2,511.89 | Professional | None | $177.83 | $1,202.26 | $2,511.89 |
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 $1,778.28 Typical High $3,548.13 | Professional | None | $60.26 | $1,778.28 | $3,548.13 |
Wellpoint Setting Professional Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $1,659.59 | Professional | None | $1,202.26 | $1,202.26 | $1,659.59 |
7 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 $660.69 Median $758.58 Typical High $891.25 | Professional | 52 · Reduced service | $660.69 | $758.58 | $891.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $269.15 Median $302.00 Typical High $354.81 | Professional | 53 · Discontinued | $269.15 | $302.00 | $354.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,000.00 Median $1,122.02 Typical High $1,318.26 | Professional | 54 · Surgery only | $1,000.00 | $1,122.02 | $1,318.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $223.87 Typical High $263.03 | Professional | 55 · Aftercare only | $199.53 | $223.87 | $263.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $134.90 Median $151.36 Typical High $177.83 | Professional | 56 · Pre-op care only | $134.90 | $151.36 | $177.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $1,047.13 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $933.25 | $1,047.13 | $1,230.27 |
Ambetter Setting Professional Modifier 58 · Staged procedure Typical Low $2,089.30 Median $2,089.30 Typical High $2,089.30 | Professional | 58 · Staged procedure | $2,089.30 | $2,089.30 | $2,089.30 |
Where Florida sits
The same service costs 7.2 times more in Alaska than in Texas. 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.
Florida· 48th of 51
$1,413
AK $6,457TX $891
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.