How much rates vary
Facilitymedian $3,388 · 10th to 90th $1,413 to $13,183Professionalmedian $813 · 10th to 90th $87 to $1,622
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 $933.25 Median $6,456.54 Typical High $14,791.08 | Facility | None | $933.25 | $6,456.54 | $14,791.08 |
Aetna Setting Professional Modifier None Typical Low $851.14 Median $933.25 Typical High $1,122.02 | Professional | None | $851.14 | $933.25 | $1,122.02 |
AvMed Setting Facility Modifier None Typical Low $851.14 Median $2,951.21 Typical High $9,549.93 | Facility | None | $851.14 | $2,951.21 | $9,549.93 |
AvMed Setting Professional Modifier None Typical Low $776.25 Median $1,000.00 Typical High $1,174.90 | Professional | None | $776.25 | $1,000.00 | $1,174.90 |
Cigna Setting Facility Modifier None Typical Low $977.24 Median $3,467.37 Typical High $5,370.32 | Facility | None | $977.24 | $3,467.37 | $5,370.32 |
Cigna Setting Professional Modifier None Typical Low $741.31 Median $1,047.13 Typical High $1,949.84 | Professional | None | $741.31 | $1,047.13 | $1,949.84 |
Florida Blue Setting Facility Modifier None Typical Low $1,737.80 Median $3,548.13 Typical High $16,982.44 | Facility | None | $1,737.80 | $3,548.13 | $16,982.44 |
Florida Blue Setting Professional Modifier None Typical Low $645.65 Median $691.83 Typical High $1,047.13 | Professional | None | $645.65 | $691.83 | $1,047.13 |
Molina Setting Professional Modifier None Typical Low $72.44 Median $676.08 Typical High $1,548.82 | Professional | None | $72.44 | $676.08 | $1,548.82 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $3,311.31 Typical High $12,589.25 | Facility | None | $1,230.27 | $3,311.31 | $12,589.25 |
United Setting Professional Modifier None Typical Low $60.26 Median $1,122.02 Typical High $2,137.96 | Professional | None | $60.26 | $1,122.02 | $2,137.96 |
Wellpoint Setting Professional Modifier None Typical Low $707.95 Median $707.95 Typical High $933.25 | Professional | None | $707.95 | $707.95 | $933.25 |
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 $426.58 Median $467.74 Typical High $549.54 | Professional | 52 · Reduced service | $426.58 | $467.74 | $549.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $190.55 Typical High $218.78 | Professional | 53 · Discontinued | $169.82 | $190.55 | $218.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $707.95 Typical High $831.76 | Professional | 54 · Surgery only | $645.65 | $707.95 | $831.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $141.25 Typical High $165.96 | Professional | 55 · Aftercare only | $128.82 | $141.25 | $165.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $93.33 Typical High $109.65 | Professional | 56 · Pre-op care only | $85.11 | $93.33 | $109.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $660.69 Typical High $776.25 | Professional | 78 · Unplanned return to OR | $602.56 | $660.69 | $776.25 |
Where Florida sits
The same service costs 3.6 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 $11,248MT $3,134
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.