How much rates vary
Facilitymedian $5,623 · 10th to 90th $1,000 to $19,498Professionalmedian $603 · 10th to 90th $166 to $4,786
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 $380.19 Median $3,090.30 Typical High $12,022.64 | Facility | None | $380.19 | $3,090.30 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $131.83 Median $173.78 Typical High $977.24 | Professional | None | $131.83 | $173.78 | $977.24 |
AvMed Setting Facility Modifier None Typical Low $501.19 Median $2,137.96 Typical High $11,481.54 | Facility | None | $501.19 | $2,137.96 | $11,481.54 |
AvMed Setting Professional Modifier None Typical Low $169.82 Median $524.81 Typical High $5,011.87 | Professional | None | $169.82 | $524.81 | $5,011.87 |
Cigna Setting Facility Modifier None Typical Low $338.84 Median $10,232.93 Typical High $19,498.45 | Facility | None | $338.84 | $10,232.93 | $19,498.45 |
Cigna Setting Professional Modifier None Typical Low $245.47 Median $478.63 Typical High $2,344.23 | Professional | None | $245.47 | $478.63 | $2,344.23 |
Florida Blue Setting Facility Modifier None Typical Low $2,884.03 Median $6,165.95 Typical High $19,952.62 | Facility | None | $2,884.03 | $6,165.95 | $19,952.62 |
Florida Blue Setting Professional Modifier None Typical Low $83.18 Median $251.19 Typical High $5,011.87 | Professional | None | $83.18 | $251.19 | $5,011.87 |
Molina Setting Professional Modifier None Typical Low $380.19 Median $3,715.35 Typical High $6,165.95 | Professional | None | $380.19 | $3,715.35 | $6,165.95 |
United Setting Facility Modifier None Typical Low $1,584.89 Median $4,677.35 Typical High $23,442.29 | Facility | None | $1,584.89 | $4,677.35 | $23,442.29 |
United Setting Professional Modifier None Typical Low $141.25 Median $338.84 Typical High $2,089.30 | Professional | None | $141.25 | $338.84 | $2,089.30 |
Wellpoint Setting Professional Modifier None Typical Low $169.82 Median $177.83 Typical High $177.83 | Professional | None | $169.82 | $177.83 | $177.83 |
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 $64.57 Median $85.11 Typical High $489.78 | Professional | 52 · Reduced service | $64.57 | $85.11 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.30 Median $34.67 Typical High $194.98 | Professional | 53 · Discontinued | $26.30 | $34.67 | $194.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $97.72 Median $128.82 Typical High $724.44 | Professional | 54 · Surgery only | $97.72 | $128.82 | $724.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $25.70 Typical High $147.91 | Professional | 55 · Aftercare only | $19.50 | $25.70 | $147.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $17.38 Typical High $97.72 | Professional | 56 · Pre-op care only | $13.18 | $17.38 | $97.72 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $91.20 Median $120.23 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $91.20 | $120.23 | $676.08 |
Where Florida sits
The same service costs 18.4 times more in Alabama 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
AL $30,876MT $1,679
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.