How much rates vary
Facilitymedian $1,950 · 10th to 90th $794 to $7,413Professionalmedian $380 · 10th to 90th $98 to $603
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 $602.56 Median $4,365.16 Typical High $11,748.98 | Facility | None | $602.56 | $4,365.16 | $11,748.98 |
Aetna Setting Professional Modifier None Typical Low $446.68 Median $467.74 Typical High $676.08 | Professional | None | $446.68 | $467.74 | $676.08 |
Ambetter Setting Professional Modifier None Typical Low $380.19 Median $758.58 Typical High $758.58 | Professional | None | $380.19 | $758.58 | $758.58 |
AvMed Setting Facility Modifier None Typical Low $501.19 Median $2,089.30 Typical High $9,772.37 | Facility | None | $501.19 | $2,089.30 | $9,772.37 |
AvMed Setting Professional Modifier None Typical Low $295.12 Median $389.05 Typical High $489.78 | Professional | None | $295.12 | $389.05 | $489.78 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $1,288.25 Typical High $2,691.53 | Facility | None | $501.19 | $1,288.25 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $309.03 Median $323.59 Typical High $758.58 | Professional | None | $309.03 | $323.59 | $758.58 |
Florida Blue Setting Facility Modifier None Typical Low $1,000.00 Median $2,187.76 Typical High $7,413.10 | Facility | None | $1,000.00 | $2,187.76 | $7,413.10 |
Florida Blue Setting Professional Modifier None Typical Low $251.19 Median $309.03 Typical High $549.54 | Professional | None | $251.19 | $309.03 | $549.54 |
Molina Setting Professional Modifier None Typical Low $60.26 Median $269.15 Typical High $478.63 | Professional | None | $60.26 | $269.15 | $478.63 |
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 $346.74 Median $489.78 Typical High $851.14 | Professional | None | $346.74 | $489.78 | $851.14 |
Wellpoint Setting Professional Modifier None Typical Low $309.03 Median $426.58 Typical High $426.58 | Professional | None | $309.03 | $426.58 | $426.58 |
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 $223.87 Median $234.42 Typical High $269.15 | Professional | 52 · Reduced service | $223.87 | $234.42 | $269.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $93.33 Typical High $107.15 | Professional | 53 · Discontinued | $89.13 | $93.33 | $107.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $331.13 Median $346.74 Typical High $407.38 | Professional | 54 · Surgery only | $331.13 | $346.74 | $407.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $69.18 Typical High $81.28 | Professional | 55 · Aftercare only | $66.07 | $69.18 | $81.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $46.77 Typical High $53.70 | Professional | 56 · Pre-op care only | $44.67 | $46.77 | $53.70 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $309.03 Median $323.59 Typical High $380.19 | Professional | 78 · Unplanned return to OR | $309.03 | $323.59 | $380.19 |
Where Florida sits
The same service costs 4.5 times more in Oklahoma 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
OK $6,371MT $1,416
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.