How much rates vary
Facilitymedian $7,244 · 10th to 90th $1,288 to $26,915Professionalmedian $214 · 10th to 90th $102 to $468
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 $229.09 Median $3,019.95 Typical High $11,748.98 | Facility | None | $229.09 | $3,019.95 | $11,748.98 |
Aetna Setting Professional Modifier None Typical Low $141.25 Median $229.09 Typical High $380.19 | Professional | None | $141.25 | $229.09 | $380.19 |
Ambetter Setting Professional Modifier None Typical Low $138.04 Median $275.42 Typical High $275.42 | Professional | None | $138.04 | $275.42 | $275.42 |
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 $177.83 Median $302.00 Typical High $446.68 | Professional | None | $177.83 | $302.00 | $446.68 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $18,197.01 Typical High $30,199.52 | Facility | None | $446.68 | $18,197.01 | $30,199.52 |
Cigna Setting Professional Modifier None Typical Low $114.82 Median $181.97 Typical High $363.08 | Professional | None | $114.82 | $181.97 | $363.08 |
Florida Blue Setting Facility Modifier None Typical Low $2,884.03 Median $5,888.44 Typical High $18,620.87 | Facility | None | $2,884.03 | $5,888.44 | $18,620.87 |
Florida Blue Setting Professional Modifier None Typical Low $117.49 Median $263.03 Typical High $467.74 | Professional | None | $117.49 | $263.03 | $467.74 |
Molina Setting Professional Modifier None Typical Low $27.54 Median $338.84 Typical High $549.54 | Professional | None | $27.54 | $338.84 | $549.54 |
United Setting Facility Modifier None Typical Low $3,890.45 Median $17,782.79 Typical High $51,286.14 | Facility | None | $3,890.45 | $17,782.79 | $51,286.14 |
United Setting Professional Modifier None Typical Low $114.82 Median $190.55 Typical High $426.58 | Professional | None | $114.82 | $190.55 | $426.58 |
Wellpoint Setting Professional Modifier None Typical Low $154.88 Median $269.15 Typical High $269.15 | Professional | None | $154.88 | $269.15 | $269.15 |
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 $70.79 Median $107.15 Typical High $138.04 | Professional | 52 · Reduced service | $70.79 | $107.15 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $43.65 Typical High $54.95 | Professional | 53 · Discontinued | $28.18 | $43.65 | $54.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $104.71 Median $162.18 Typical High $208.93 | Professional | 54 · Surgery only | $104.71 | $162.18 | $208.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $32.36 Typical High $41.69 | Professional | 55 · Aftercare only | $20.89 | $32.36 | $41.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $21.38 Typical High $27.54 | Professional | 56 · Pre-op care only | $14.13 | $21.38 | $27.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $97.72 Median $151.36 Typical High $194.98 | Professional | 78 · Unplanned return to OR | $97.72 | $151.36 | $194.98 |
Ambetter Setting Professional Modifier 51 · Multiple procedures Typical Low $138.04 Median $138.04 Typical High $239.88 | Professional | 51 · Multiple procedures | $138.04 | $138.04 | $239.88 |
Where Florida sits
The same service costs 45.2 times more in Alaska than in West Virginia. 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 $35,770WV $791
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.