How much rates vary
Facilitymedian $479 · 10th to 90th $200 to $4,786Professionalmedian $204 · 10th to 90th $135 to $324
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 $245.47 Median $2,884.03 Typical High $10,964.78 | Facility | None | $245.47 | $2,884.03 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $154.88 Median $213.80 Typical High $323.59 | Professional | None | $154.88 | $213.80 | $323.59 |
Ambetter Setting Professional Modifier None Typical Low $107.15 Median $125.89 Typical High $234.42 | Professional | None | $107.15 | $125.89 | $234.42 |
AvMed Setting Facility Modifier None Typical Low $181.97 Median $2,137.96 Typical High $11,748.98 | Facility | None | $181.97 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $173.78 Median $229.09 Typical High $302.00 | Professional | None | $173.78 | $229.09 | $302.00 |
Cigna Setting Facility Modifier None Typical Low $169.82 Median $302.00 Typical High $1,659.59 | Facility | None | $169.82 | $302.00 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $141.25 Median $204.17 Typical High $323.59 | Professional | None | $141.25 | $204.17 | $323.59 |
Florida Blue Setting Facility Modifier None Typical Low $199.53 Median $436.52 Typical High $4,466.84 | Facility | None | $199.53 | $436.52 | $4,466.84 |
Florida Blue Setting Professional Modifier None Typical Low $190.55 Median $204.17 Typical High $309.03 | Professional | None | $190.55 | $204.17 | $309.03 |
Molina Setting Professional Modifier None Typical Low $34.67 Median $213.80 Typical High $323.59 | Professional | None | $34.67 | $213.80 | $323.59 |
United Setting Facility Modifier None Typical Low $281.84 Median $660.69 Typical High $4,073.80 | Facility | None | $281.84 | $660.69 | $4,073.80 |
United Setting Professional Modifier None Typical Low $125.89 Median $199.53 Typical High $354.81 | Professional | None | $125.89 | $199.53 | $354.81 |
Wellpoint Setting Professional Modifier None Typical Low $134.90 Median $213.80 Typical High $213.80 | Professional | None | $134.90 | $213.80 | $213.80 |
8 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 $77.62 Median $107.15 Typical High $123.03 | Professional | 52 · Reduced service | $77.62 | $107.15 | $123.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $42.66 Typical High $48.98 | Professional | 53 · Discontinued | $30.90 | $42.66 | $48.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $117.49 Median $162.18 Typical High $181.97 | Professional | 54 · Surgery only | $117.49 | $162.18 | $181.97 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $32.36 Typical High $36.31 | Professional | 55 · Aftercare only | $23.44 | $32.36 | $36.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $21.38 Typical High $24.55 | Professional | 56 · Pre-op care only | $15.49 | $21.38 | $24.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $109.65 Median $151.36 Typical High $169.82 | Professional | 78 · Unplanned return to OR | $109.65 | $151.36 | $169.82 |
Ambetter Setting Professional Modifier 51 · Multiple procedures Typical Low $125.89 Median $138.04 Typical High $213.80 | Professional | 51 · Multiple procedures | $125.89 | $138.04 | $213.80 |
Ambetter Setting Professional Modifier 79 · Unrelated procedure after surgery Typical Low $107.15 Median $107.15 Typical High $125.89 | Professional | 79 · Unrelated procedure after surgery | $107.15 | $107.15 | $125.89 |
Where Florida sits
The same service costs 3.6 times more in Alaska than in Texas. 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· 48th of 51
$229
AK $776TX $214
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.