How much rates vary
Facilitymedian $7,244 · 10th to 90th $1,318 to $33,113Professionalmedian $501 · 10th to 90th $76 to $955
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 $549.54 Median $3,890.45 Typical High $12,022.64 | Facility | None | $549.54 | $3,890.45 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $467.74 Median $537.03 Typical High $794.33 | Professional | None | $467.74 | $537.03 | $794.33 |
Ambetter Setting Professional Modifier None Typical Low $794.33 Median $794.33 Typical High $794.33 | Professional | None | $794.33 | $794.33 | $794.33 |
AvMed Setting Facility Modifier None Typical Low $501.19 Median $1,995.26 Typical High $13,182.57 | Facility | None | $501.19 | $1,995.26 | $13,182.57 |
AvMed Setting Professional Modifier None Typical Low $501.19 Median $602.56 Typical High $691.83 | Professional | None | $501.19 | $602.56 | $691.83 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $29,512.09 Typical High $50,118.72 | Facility | None | $446.68 | $29,512.09 | $50,118.72 |
Cigna Setting Professional Modifier None Typical Low $398.11 Median $549.54 Typical High $1,071.52 | Professional | None | $398.11 | $549.54 | $1,071.52 |
Florida Blue Setting Facility Modifier None Typical Low $2,818.38 Median $5,754.40 Typical High $17,782.79 | Facility | None | $2,818.38 | $5,754.40 | $17,782.79 |
Florida Blue Setting Professional Modifier None Typical Low $407.38 Median $436.52 Typical High $676.08 | Professional | None | $407.38 | $436.52 | $676.08 |
Molina Setting Professional Modifier None Typical Low $69.18 Median $478.63 Typical High $954.99 | Professional | None | $69.18 | $478.63 | $954.99 |
United Setting Facility Modifier None Typical Low $3,630.78 Median $17,782.79 Typical High $45,708.82 | Facility | None | $3,630.78 | $17,782.79 | $45,708.82 |
United Setting Professional Modifier None Typical Low $60.26 Median $602.56 Typical High $1,148.15 | Professional | None | $60.26 | $602.56 | $1,148.15 |
Wellpoint Setting Professional Modifier None Typical Low $436.52 Median $436.52 Typical High $588.84 | Professional | None | $436.52 | $436.52 | $588.84 |
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 $234.42 Median $239.88 Typical High $295.12 | Professional | 52 · Reduced service | $234.42 | $239.88 | $295.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $97.72 Typical High $120.23 | Professional | 53 · Discontinued | $93.33 | $97.72 | $120.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $354.81 Median $363.08 Typical High $446.68 | Professional | 54 · Surgery only | $354.81 | $363.08 | $446.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $72.44 Typical High $89.13 | Professional | 55 · Aftercare only | $70.79 | $72.44 | $89.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $47.86 Typical High $58.88 | Professional | 56 · Pre-op care only | $46.77 | $47.86 | $58.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $331.13 Median $338.84 Typical High $416.87 | Professional | 78 · Unplanned return to OR | $331.13 | $338.84 | $416.87 |
Where Florida sits
The same service costs 24.6 times more in Alaska than in Montana. 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
AK $43,875MT $1,787
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.