How much rates vary
Facilitymedian $9,772 · 10th to 90th $1,778 to $35,481Professionalmedian $692 · 10th to 90th $513 to $1,230
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 $794.33 Median $8,709.64 Typical High $18,620.87 | Facility | None | $794.33 | $8,709.64 | $18,620.87 |
Aetna Setting Professional Modifier None Typical Low $588.84 Median $616.60 Typical High $1,202.26 | Professional | None | $588.84 | $616.60 | $1,202.26 |
Ambetter Setting Professional Modifier None Typical Low $630.96 Median $691.83 Typical High $912.01 | Professional | None | $630.96 | $691.83 | $912.01 |
AvMed Setting Facility Modifier None Typical Low $575.44 Median $6,309.57 Typical High $44,668.36 | Facility | None | $575.44 | $6,309.57 | $44,668.36 |
AvMed Setting Professional Modifier None Typical Low $549.54 Median $676.08 Typical High $794.33 | Professional | None | $549.54 | $676.08 | $794.33 |
Cigna Setting Facility Modifier None Typical Low $7,413.10 Median $10,232.93 Typical High $23,988.33 | Facility | None | $7,413.10 | $10,232.93 | $23,988.33 |
Cigna Setting Professional Modifier None Typical Low $501.19 Median $724.44 Typical High $1,380.38 | Professional | None | $501.19 | $724.44 | $1,380.38 |
Florida Blue Setting Facility Modifier None Typical Low $4,897.79 Median $22,387.21 Typical High $40,738.03 | Facility | None | $4,897.79 | $22,387.21 | $40,738.03 |
Florida Blue Setting Professional Modifier None Typical Low $478.63 Median $501.19 Typical High $758.58 | Professional | None | $478.63 | $501.19 | $758.58 |
Molina Setting Professional Modifier None Typical Low $549.54 Median $724.44 Typical High $1,000.00 | Professional | None | $549.54 | $724.44 | $1,000.00 |
United Setting Facility Modifier None Typical Low $1,584.89 Median $4,677.35 Typical High $26,915.35 | Facility | None | $1,584.89 | $4,677.35 | $26,915.35 |
United Setting Professional Modifier None Typical Low $588.84 Median $870.96 Typical High $1,778.28 | Professional | None | $588.84 | $870.96 | $1,778.28 |
Wellpoint Setting Professional Modifier None Typical Low $489.78 Median $489.78 Typical High $707.95 | Professional | None | $489.78 | $489.78 | $707.95 |
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 $281.84 Median $309.03 Typical High $346.74 | Professional | 52 · Reduced service | $281.84 | $309.03 | $346.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $123.03 Typical High $141.25 | Professional | 53 · Discontinued | $112.20 | $123.03 | $141.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $416.87 Median $457.09 Typical High $524.81 | Professional | 54 · Surgery only | $416.87 | $457.09 | $524.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $93.33 Typical High $104.71 | Professional | 55 · Aftercare only | $83.18 | $93.33 | $104.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $61.66 Typical High $69.18 | Professional | 56 · Pre-op care only | $56.23 | $61.66 | $69.18 |
Where Florida sits
The same service costs 9.6 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 $19,472MT $2,030
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.