How much rates vary
Facilitymedian $3,548 · 10th to 90th $1,349 to $13,183Professionalmedian $525 · 10th to 90th $145 to $871
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 $6,025.60 Typical High $13,182.57 | Facility | None | $776.25 | $6,025.60 | $13,182.57 |
Aetna Setting Professional Modifier None Typical Low $501.19 Median $524.81 Typical High $758.58 | Professional | None | $501.19 | $524.81 | $758.58 |
Ambetter Setting Professional Modifier None Typical Low $398.11 Median $537.03 Typical High $1,202.26 | Professional | None | $398.11 | $537.03 | $1,202.26 |
AvMed Setting Facility Modifier None Typical Low $588.84 Median $2,137.96 Typical High $9,772.37 | Facility | None | $588.84 | $2,137.96 | $9,772.37 |
AvMed Setting Professional Modifier None Typical Low $436.52 Median $588.84 Typical High $630.96 | Professional | None | $436.52 | $588.84 | $630.96 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $4,365.16 Typical High $7,244.36 | Facility | None | $489.78 | $4,365.16 | $7,244.36 |
Cigna Setting Professional Modifier None Typical Low $467.74 Median $489.78 Typical High $1,023.29 | Professional | None | $467.74 | $489.78 | $1,023.29 |
Florida Blue Setting Facility Modifier None Typical Low $1,621.81 Median $3,467.37 Typical High $16,982.44 | Facility | None | $1,621.81 | $3,467.37 | $16,982.44 |
Florida Blue Setting Professional Modifier None Typical Low $295.12 Median $457.09 Typical High $724.44 | Professional | None | $295.12 | $457.09 | $724.44 |
Molina Setting Professional Modifier None Typical Low $77.62 Median $407.38 Typical High $812.83 | Professional | None | $77.62 | $407.38 | $812.83 |
United Setting Facility Modifier None Typical Low $1,318.26 Median $3,311.31 Typical High $12,589.25 | Facility | None | $1,318.26 | $3,311.31 | $12,589.25 |
United Setting Professional Modifier None Typical Low $489.78 Median $630.96 Typical High $1,096.48 | Professional | None | $489.78 | $630.96 | $1,096.48 |
Wellpoint Setting Professional Modifier None Typical Low $588.84 Median $630.96 Typical High $630.96 | Professional | None | $588.84 | $630.96 | $630.96 |
5 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 $251.19 Median $263.03 Typical High $371.54 | Professional | 52 · Reduced service | $251.19 | $263.03 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $104.71 Typical High $151.36 | Professional | 53 · Discontinued | $100.00 | $104.71 | $151.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $398.11 Typical High $549.54 | Professional | 54 · Surgery only | $380.19 | $398.11 | $549.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $79.43 Typical High $112.20 | Professional | 55 · Aftercare only | $75.86 | $79.43 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $52.48 Typical High $75.86 | Professional | 56 · Pre-op care only | $50.12 | $52.48 | $75.86 |
Where Florida sits
The same service costs 5.9 times more in Alaska 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
AK $12,304MT $2,095
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.