How much rates vary
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 $169.82 Median $2,344.23 Typical High $10,715.19 | Facility | None | $169.82 | $2,344.23 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $131.83 Median $173.78 Typical High $263.03 | Professional | None | $131.83 | $173.78 | $263.03 |
Ambetter Setting Professional Modifier None Typical Low $89.13 Median $141.25 Typical High $234.42 | Professional | None | $89.13 | $141.25 | $234.42 |
AvMed Setting Facility Modifier None Typical Low $257.04 Median $1,288.25 Typical High $9,549.93 | Facility | None | $257.04 | $1,288.25 | $9,549.93 |
AvMed Setting Professional Modifier None Typical Low $154.88 Median $194.98 Typical High $257.04 | Professional | None | $154.88 | $194.98 | $257.04 |
Cigna Setting Facility Modifier None Typical Low $323.59 Median $870.96 Typical High $1,659.59 | Facility | None | $323.59 | $870.96 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $123.03 Median $165.96 Typical High $269.15 | Professional | None | $123.03 | $165.96 | $269.15 |
Florida Blue Setting Facility Modifier None Typical Low $616.60 Median $1,348.96 Typical High $6,309.57 | Facility | None | $616.60 | $1,348.96 | $6,309.57 |
Florida Blue Setting Professional Modifier None Typical Low $162.18 Median $177.83 Typical High $263.03 | Professional | None | $162.18 | $177.83 | $263.03 |
Molina Setting Professional Modifier None Typical Low $151.36 Median $208.93 Typical High $302.00 | Professional | None | $151.36 | $208.93 | $302.00 |
United Setting Facility Modifier None Typical Low $398.11 Median $1,000.00 Typical High $5,623.41 | Facility | None | $398.11 | $1,000.00 | $5,623.41 |
United Setting Professional Modifier None Typical Low $107.15 Median $162.18 Typical High $295.12 | Professional | None | $107.15 | $162.18 | $295.12 |
Wellpoint Setting Professional Modifier None Typical Low $117.49 Median $177.83 Typical High $177.83 | Professional | None | $117.49 | $177.83 | $177.83 |
7 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 $63.10 Median $81.28 Typical High $93.33 | Professional | 52 · Reduced service | $63.10 | $81.28 | $93.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $32.36 Typical High $38.02 | Professional | 53 · Discontinued | $25.12 | $32.36 | $38.02 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $93.33 Median $120.23 Typical High $141.25 | Professional | 54 · Surgery only | $93.33 | $120.23 | $141.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $24.55 Typical High $28.18 | Professional | 55 · Aftercare only | $19.05 | $24.55 | $28.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $16.22 Typical High $19.05 | Professional | 56 · Pre-op care only | $12.59 | $16.22 | $19.05 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $87.10 Median $112.20 Typical High $131.83 | Professional | 78 · Unplanned return to OR | $87.10 | $112.20 | $131.83 |
Ambetter Setting Professional Modifier 51 · Multiple procedures Typical Low $89.13 Median $104.71 Typical High $165.96 | Professional | 51 · Multiple procedures | $89.13 | $104.71 | $165.96 |
Where Florida sits
The same service costs 4.6 times more in Alaska than in Kentucky. 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.
Florida· 39th of 51
$219
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.