How much rates vary
Facilitymedian $2,399 · 10th to 90th $437 to $24,547Professionalmedian $933 · 10th to 90th $166 to $1,738
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 $851.14 Median $1,000.00 Typical High $1,202.26 | Professional | None | $851.14 | $1,000.00 | $1,202.26 |
AvMed Setting Facility Modifier None Typical Low $831.76 Median $2,137.96 Typical High $11,748.98 | Facility | None | $831.76 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $891.25 Median $1,071.52 Typical High $1,288.25 | Professional | None | $891.25 | $1,071.52 | $1,288.25 |
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 $741.31 Median $1,023.29 Typical High $2,089.30 | Professional | None | $741.31 | $1,023.29 | $2,089.30 |
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 $724.44 Median $776.25 Typical High $1,071.52 | Professional | None | $724.44 | $776.25 | $1,071.52 |
Molina Setting Professional Modifier None Typical Low $147.91 Median $891.25 Typical High $1,737.80 | Professional | None | $147.91 | $891.25 | $1,737.80 |
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 $1,148.15 Typical High $2,290.87 | Professional | None | $60.26 | $1,148.15 | $2,290.87 |
Wellpoint Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $1,047.13 | Professional | None | $758.58 | $758.58 | $1,047.13 |
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 $426.58 Median $478.63 Typical High $562.34 | Professional | 52 · Reduced service | $426.58 | $478.63 | $562.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $190.55 Typical High $223.87 | Professional | 53 · Discontinued | $169.82 | $190.55 | $223.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $707.95 Typical High $851.14 | Professional | 54 · Surgery only | $645.65 | $707.95 | $851.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $141.25 Typical High $169.82 | Professional | 55 · Aftercare only | $128.82 | $141.25 | $169.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $95.50 Typical High $112.20 | Professional | 56 · Pre-op care only | $85.11 | $95.50 | $112.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $660.69 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $602.56 | $660.69 | $794.33 |
Where Florida sits
The same service costs 9.8 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 $16,204MD $1,659
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.