How much rates vary
Facilitymedian $1,259 · 10th to 90th $447 to $6,026Professionalmedian $251 · 10th to 90th $178 to $407
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 $234.42 Median $2,089.30 Typical High $10,000.00 | Facility | None | $234.42 | $2,089.30 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $204.17 Median $257.04 Typical High $398.11 | Professional | None | $204.17 | $257.04 | $398.11 |
Ambetter Setting Professional Modifier None Typical Low $138.04 Median $213.80 Typical High $309.03 | Professional | None | $138.04 | $213.80 | $309.03 |
AvMed Setting Facility Modifier None Typical Low $354.81 Median $1,479.11 Typical High $9,549.93 | Facility | None | $354.81 | $1,479.11 | $9,549.93 |
AvMed Setting Professional Modifier None Typical Low $234.42 Median $281.84 Typical High $371.54 | Professional | None | $234.42 | $281.84 | $371.54 |
Cigna Setting Facility Modifier None Typical Low $436.52 Median $870.96 Typical High $2,187.76 | Facility | None | $436.52 | $870.96 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $186.21 Median $239.88 Typical High $389.05 | Professional | None | $186.21 | $239.88 | $389.05 |
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 $218.78 Median $251.19 Typical High $380.19 | Professional | None | $218.78 | $251.19 | $380.19 |
Molina Setting Professional Modifier None Typical Low $31.62 Median $275.42 Typical High $426.58 | Professional | None | $31.62 | $275.42 | $426.58 |
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 $165.96 Median $239.88 Typical High $426.58 | Professional | None | $165.96 | $239.88 | $426.58 |
Wellpoint Setting Professional Modifier None Typical Low $177.83 Median $257.04 Typical High $257.04 | Professional | None | $177.83 | $257.04 | $257.04 |
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 $97.72 Median $117.49 Typical High $138.04 | Professional | 52 · Reduced service | $97.72 | $117.49 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $46.77 Typical High $54.95 | Professional | 53 · Discontinued | $38.90 | $46.77 | $54.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $144.54 Median $177.83 Typical High $204.17 | Professional | 54 · Surgery only | $144.54 | $177.83 | $204.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $35.48 Typical High $40.74 | Professional | 55 · Aftercare only | $28.84 | $35.48 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $23.44 Typical High $27.54 | Professional | 56 · Pre-op care only | $19.50 | $23.44 | $27.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $134.90 Median $165.96 Typical High $190.55 | Professional | 78 · Unplanned return to OR | $134.90 | $165.96 | $190.55 |
Ambetter Setting Professional Modifier 79 · Unrelated procedure after surgery Typical Low $151.36 Median $151.36 Typical High $257.04 | Professional | 79 · Unrelated procedure after surgery | $151.36 | $151.36 | $257.04 |
Where Florida sits
The same service costs 4.8 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· 38th of 51
$309
AK $1,202KY $251
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.