How much rates vary
Facilitymedian $741 · 10th to 90th $324 to $3,890Professionalmedian $129 · 10th to 90th $79 to $214
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 $141.25 Median $2,818.38 Typical High $10,964.78 | Facility | None | $141.25 | $2,818.38 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $91.20 Median $131.83 Typical High $199.53 | Professional | None | $91.20 | $131.83 | $199.53 |
Ambetter Setting Professional Modifier None Typical Low $97.72 Median $190.55 Typical High $489.78 | Professional | None | $97.72 | $190.55 | $489.78 |
AvMed Setting Facility Modifier None Typical Low $169.82 Median $1,000.00 Typical High $2,398.83 | Facility | None | $169.82 | $1,000.00 | $2,398.83 |
AvMed Setting Professional Modifier None Typical Low $107.15 Median $144.54 Typical High $186.21 | Professional | None | $107.15 | $144.54 | $186.21 |
Cigna Setting Facility Modifier None Typical Low $323.59 Median $457.09 Typical High $1,659.59 | Facility | None | $323.59 | $457.09 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $79.43 Median $117.49 Typical High $213.80 | Professional | None | $79.43 | $117.49 | $213.80 |
Florida Blue Setting Facility Modifier None Typical Low $363.08 Median $776.25 Typical High $4,466.84 | Facility | None | $363.08 | $776.25 | $4,466.84 |
Florida Blue Setting Professional Modifier None Typical Low $66.07 Median $138.04 Typical High $186.21 | Professional | None | $66.07 | $138.04 | $186.21 |
Molina Setting Professional Modifier None Typical Low $87.10 Median $144.54 Typical High $239.88 | Professional | None | $87.10 | $144.54 | $239.88 |
United Setting Facility Modifier None Typical Low $281.84 Median $660.69 Typical High $4,073.80 | Facility | None | $281.84 | $660.69 | $4,073.80 |
United Setting Professional Modifier None Typical Low $75.86 Median $123.03 Typical High $245.47 | Professional | None | $75.86 | $123.03 | $245.47 |
Wellpoint Setting Professional Modifier None Typical Low $79.43 Median $134.90 Typical High $134.90 | Professional | None | $79.43 | $134.90 | $134.90 |
5 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 $45.71 Median $66.07 Typical High $81.28 | Professional | 52 · Reduced service | $45.71 | $66.07 | $81.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.20 Median $26.30 Typical High $33.11 | Professional | 53 · Discontinued | $18.20 | $26.30 | $33.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $69.18 Median $97.72 Typical High $123.03 | Professional | 54 · Surgery only | $69.18 | $97.72 | $123.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $19.50 Typical High $24.55 | Professional | 55 · Aftercare only | $13.80 | $19.50 | $24.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $13.18 Typical High $16.22 | Professional | 56 · Pre-op care only | $9.12 | $13.18 | $16.22 |
Where Florida sits
The same service costs 6.3 times more in New York 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
NY $2,712MT $427
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.