How much rates vary
Facilitymedian $7,586 · 10th to 90th $1,318 to $25,119Professionalmedian $331 · 10th to 90th $245 to $550
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 $524.81 Median $3,801.89 Typical High $12,022.64 | Facility | None | $524.81 | $3,801.89 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $338.84 Median $346.74 Typical High $457.09 | Professional | None | $338.84 | $346.74 | $457.09 |
Ambetter Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $363.08 | Professional | None | $363.08 | $363.08 | $363.08 |
AvMed Setting Facility Modifier None Typical Low $446.68 Median $1,995.26 Typical High $13,182.57 | Facility | None | $446.68 | $1,995.26 | $13,182.57 |
AvMed Setting Professional Modifier None Typical Low $309.03 Median $407.38 Typical High $489.78 | Professional | None | $309.03 | $407.38 | $489.78 |
Cigna Setting Facility Modifier None Typical Low $436.52 Median $17,378.01 Typical High $27,542.29 | Facility | None | $436.52 | $17,378.01 | $27,542.29 |
Cigna Setting Professional Modifier None Typical Low $281.84 Median $302.00 Typical High $630.96 | Professional | None | $281.84 | $302.00 | $630.96 |
Florida Blue Setting Facility Modifier None Typical Low $2,884.03 Median $6,309.57 Typical High $19,952.62 | Facility | None | $2,884.03 | $6,309.57 | $19,952.62 |
Florida Blue Setting Professional Modifier None Typical Low $169.82 Median $363.08 Typical High $467.74 | Professional | None | $169.82 | $363.08 | $467.74 |
Molina Setting Professional Modifier None Typical Low $36.31 Median $295.12 Typical High $489.78 | Professional | None | $36.31 | $295.12 | $489.78 |
United Setting Facility Modifier None Typical Low $3,890.45 Median $17,782.79 Typical High $35,481.34 | Facility | None | $3,890.45 | $17,782.79 | $35,481.34 |
United Setting Professional Modifier None Typical Low $263.03 Median $346.74 Typical High $660.69 | Professional | None | $263.03 | $346.74 | $660.69 |
Wellpoint Setting Professional Modifier None Typical Low $288.40 Median $288.40 Typical High $389.05 | Professional | None | $288.40 | $288.40 | $389.05 |
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 $165.96 Median $173.78 Typical High $218.78 | Professional | 52 · Reduced service | $165.96 | $173.78 | $218.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $69.18 Typical High $87.10 | Professional | 53 · Discontinued | $67.61 | $69.18 | $87.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $263.03 Typical High $331.13 | Professional | 54 · Surgery only | $251.19 | $263.03 | $331.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $52.48 Typical High $66.07 | Professional | 55 · Aftercare only | $50.12 | $52.48 | $66.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $34.67 Typical High $43.65 | Professional | 56 · Pre-op care only | $33.88 | $34.67 | $43.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $234.42 Median $245.47 Typical High $309.03 | Professional | 78 · Unplanned return to OR | $234.42 | $245.47 | $309.03 |
Where Florida sits
The same service costs 29.4 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 $37,066MT $1,262
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.