How much rates vary
Facilitymedian $2,570 · 10th to 90th $437 to $24,547Professionalmedian $1,905 · 10th to 90th $269 to $3,020
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 $1,949.84 Median $2,187.76 Typical High $2,754.23 | Professional | None | $1,949.84 | $2,187.76 | $2,754.23 |
AvMed Setting Facility Modifier None Typical Low $1,445.44 Median $2,511.89 Typical High $11,748.98 | Facility | None | $1,445.44 | $2,511.89 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $1,905.46 Median $2,454.71 Typical High $2,951.21 | Professional | None | $1,905.46 | $2,454.71 | $2,951.21 |
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 $1,737.80 Median $1,905.46 Typical High $3,715.35 | Professional | None | $1,737.80 | $1,905.46 | $3,715.35 |
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 $1,023.29 Median $2,187.76 Typical High $2,630.27 | Professional | None | $1,023.29 | $2,187.76 | $2,630.27 |
Molina Setting Professional Modifier None Typical Low $229.09 Median $1,659.59 Typical High $2,818.38 | Professional | None | $229.09 | $1,659.59 | $2,818.38 |
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 $1,584.89 Median $2,041.74 Typical High $4,073.80 | Professional | None | $1,584.89 | $2,041.74 | $4,073.80 |
Wellpoint Setting Professional Modifier None Typical Low $1,737.80 Median $1,737.80 Typical High $2,398.83 | Professional | None | $1,737.80 | $1,737.80 | $2,398.83 |
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 $977.24 Median $1,096.48 Typical High $1,318.26 | Professional | 52 · Reduced service | $977.24 | $1,096.48 | $1,318.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $398.11 Median $436.52 Typical High $524.81 | Professional | 53 · Discontinued | $398.11 | $436.52 | $524.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,479.11 Median $1,659.59 Typical High $1,949.84 | Professional | 54 · Surgery only | $1,479.11 | $1,659.59 | $1,949.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $295.12 Median $331.13 Typical High $389.05 | Professional | 55 · Aftercare only | $295.12 | $331.13 | $389.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $194.98 Median $218.78 Typical High $263.03 | Professional | 56 · Pre-op care only | $194.98 | $218.78 | $263.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,380.38 Median $1,548.82 Typical High $1,819.70 | Professional | 78 · Unplanned return to OR | $1,380.38 | $1,548.82 | $1,819.70 |
Ambetter Setting Professional Modifier AS · PA/NP assist Typical Low $436.52 Median $436.52 Typical High $436.52 | Professional | AS · PA/NP assist | $436.52 | $436.52 | $436.52 |
Where Florida sits
The same service costs 12.4 times more in Maine than in Washington. 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 $35,178WA $2,843
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.