How much rates vary
Facilitymedian $2,399 · 10th to 90th $437 to $24,547Professionalmedian $1,380 · 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 $3,890.45 Typical High $12,022.64 | Facility | None | $776.25 | $3,890.45 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $1,288.25 Median $1,479.11 Typical High $1,905.46 | Professional | None | $1,288.25 | $1,479.11 | $1,905.46 |
AvMed Setting Facility Modifier None Typical Low $1,288.25 Median $2,137.96 Typical High $11,748.98 | Facility | None | $1,288.25 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $1,380.38 Median $1,659.59 Typical High $1,949.84 | Professional | None | $1,380.38 | $1,659.59 | $1,949.84 |
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 $1,148.15 Median $1,584.89 Typical High $3,162.28 | Professional | None | $1,148.15 | $1,584.89 | $3,162.28 |
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 $1,148.15 Median $1,230.27 Typical High $1,621.81 | Professional | None | $1,148.15 | $1,230.27 | $1,621.81 |
Molina Setting Professional Modifier None Typical Low $177.83 Median $1,230.27 Typical High $2,570.40 | Professional | None | $177.83 | $1,230.27 | $2,570.40 |
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 $3,388.44 | Professional | None | $60.26 | $1,778.28 | $3,388.44 |
Wellpoint Setting Professional Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $1,621.81 | Professional | None | $1,174.90 | $1,174.90 | $1,621.81 |
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 $645.65 Median $724.44 Typical High $851.14 | Professional | 52 · Reduced service | $645.65 | $724.44 | $851.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $257.04 Median $295.12 Typical High $338.84 | Professional | 53 · Discontinued | $257.04 | $295.12 | $338.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $977.24 Median $1,096.48 Typical High $1,288.25 | Professional | 54 · Surgery only | $977.24 | $1,096.48 | $1,288.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $218.78 Typical High $257.04 | Professional | 55 · Aftercare only | $194.98 | $218.78 | $257.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $147.91 Typical High $169.82 | Professional | 56 · Pre-op care only | $128.82 | $147.91 | $169.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $912.01 Median $1,023.29 Typical High $1,202.26 | Professional | 78 · Unplanned return to OR | $912.01 | $1,023.29 | $1,202.26 |
Ambetter Setting Professional Modifier 79 · Unrelated procedure after surgery Typical Low $2,818.38 Median $2,818.38 Typical High $2,818.38 | Professional | 79 · Unrelated procedure after surgery | $2,818.38 | $2,818.38 | $2,818.38 |
Where Florida sits
The same service costs 15.5 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 $34,449MD $2,222
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.