How much rates vary
Facilitymedian $6,310 · 10th to 90th $1,000 to $25,119Professionalmedian $251 · 10th to 90th $71 to $407
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 $407.38 Median $3,311.31 Typical High $12,022.64 | Facility | None | $407.38 | $3,311.31 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $251.19 Median $275.42 Typical High $363.08 | Professional | None | $251.19 | $275.42 | $363.08 |
AvMed Setting Facility Modifier None Typical Low $331.13 Median $1,548.82 Typical High $12,882.50 | Facility | None | $331.13 | $1,548.82 | $12,882.50 |
AvMed Setting Professional Modifier None Typical Low $263.03 Median $316.23 Typical High $380.19 | Professional | None | $263.03 | $316.23 | $380.19 |
Cigna Setting Facility Modifier None Typical Low $338.84 Median $15,135.61 Typical High $28,840.32 | Facility | None | $338.84 | $15,135.61 | $28,840.32 |
Cigna Setting Professional Modifier None Typical Low $229.09 Median $245.47 Typical High $489.78 | Professional | None | $229.09 | $245.47 | $489.78 |
Florida Blue Setting Facility Modifier None Typical Low $2,884.03 Median $5,888.44 Typical High $16,982.44 | Facility | None | $2,884.03 | $5,888.44 | $16,982.44 |
Florida Blue Setting Professional Modifier None Typical Low $128.82 Median $281.84 Typical High $354.81 | Professional | None | $128.82 | $281.84 | $354.81 |
Molina Setting Professional Modifier None Typical Low $54.95 Median $229.09 Typical High $398.11 | Professional | None | $54.95 | $229.09 | $398.11 |
United Setting Facility Modifier None Typical Low $2,511.89 Median $10,000.00 Typical High $36,307.81 | Facility | None | $2,511.89 | $10,000.00 | $36,307.81 |
United Setting Professional Modifier None Typical Low $204.17 Median $263.03 Typical High $524.81 | Professional | None | $204.17 | $263.03 | $524.81 |
Wellpoint Setting Professional Modifier None Typical Low $245.47 Median $245.47 Typical High $323.59 | Professional | None | $245.47 | $245.47 | $323.59 |
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 $125.89 Median $138.04 Typical High $177.83 | Professional | 52 · Reduced service | $125.89 | $138.04 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $50.12 Median $54.95 Typical High $72.44 | Professional | 53 · Discontinued | $50.12 | $54.95 | $72.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $186.21 Median $204.17 Typical High $269.15 | Professional | 54 · Surgery only | $186.21 | $204.17 | $269.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $40.74 Typical High $53.70 | Professional | 55 · Aftercare only | $37.15 | $40.74 | $53.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.12 Median $27.54 Typical High $36.31 | Professional | 56 · Pre-op care only | $25.12 | $27.54 | $36.31 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $173.78 Median $190.55 Typical High $251.19 | Professional | 78 · Unplanned return to OR | $173.78 | $190.55 | $251.19 |
Where Florida sits
The same service costs 29.1 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 $30,626MT $1,051
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.