How much rates vary
Facilitymedian $1,622 · 10th to 90th $676 to $7,413Professionalmedian $589 · 10th to 90th $81 to $955
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 $645.65 Median $4,786.30 Typical High $11,748.98 | Facility | None | $645.65 | $4,786.30 | $11,748.98 |
Aetna Setting Professional Modifier None Typical Low $588.84 Median $645.65 Typical High $851.14 | Professional | None | $588.84 | $645.65 | $851.14 |
Ambetter Setting Professional Modifier None Typical Low $660.69 Median $933.25 Typical High $933.25 | Professional | None | $660.69 | $933.25 | $933.25 |
AvMed Setting Facility Modifier None Typical Low $588.84 Median $2,041.74 Typical High $9,772.37 | Facility | None | $588.84 | $2,041.74 | $9,772.37 |
AvMed Setting Professional Modifier None Typical Low $562.34 Median $724.44 Typical High $831.76 | Professional | None | $562.34 | $724.44 | $831.76 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $1,122.02 Typical High $2,691.53 | Facility | None | $501.19 | $1,122.02 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $524.81 Median $549.54 Typical High $1,148.15 | Professional | None | $524.81 | $549.54 | $1,148.15 |
Florida Blue Setting Facility Modifier None Typical Low $741.31 Median $1,621.81 Typical High $7,413.10 | Facility | None | $741.31 | $1,621.81 | $7,413.10 |
Florida Blue Setting Professional Modifier None Typical Low $302.00 Median $630.96 Typical High $758.58 | Professional | None | $302.00 | $630.96 | $758.58 |
Molina Setting Professional Modifier None Typical Low $58.88 Median $549.54 Typical High $891.25 | Professional | None | $58.88 | $549.54 | $891.25 |
United Setting Facility Modifier None Typical Low $794.33 Median $1,778.28 Typical High $7,585.78 | Facility | None | $794.33 | $1,778.28 | $7,585.78 |
United Setting Professional Modifier None Typical Low $478.63 Median $630.96 Typical High $1,230.27 | Professional | None | $478.63 | $630.96 | $1,230.27 |
Wellpoint Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $691.83 | Professional | None | $524.81 | $524.81 | $691.83 |
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 $295.12 Median $323.59 Typical High $416.87 | Professional | 52 · Reduced service | $295.12 | $323.59 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $117.49 Median $128.82 Typical High $165.96 | Professional | 53 · Discontinued | $117.49 | $128.82 | $165.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $446.68 Median $489.78 Typical High $616.60 | Professional | 54 · Surgery only | $446.68 | $489.78 | $616.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $97.72 Typical High $125.89 | Professional | 55 · Aftercare only | $89.13 | $97.72 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $58.88 Median $64.57 Typical High $83.18 | Professional | 56 · Pre-op care only | $58.88 | $64.57 | $83.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $416.87 Median $457.09 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $416.87 | $457.09 | $575.44 |
Where Florida sits
The same service costs 3.0 times more in Alaska than in Maryland. 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 $5,643MD $1,856
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.