How much rates vary
Facilitymedian $776 · 10th to 90th $339 to $4,677Professionalmedian $234 · 10th to 90th $151 to $363
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 $269.15 Median $3,019.95 Typical High $10,964.78 | Facility | None | $269.15 | $3,019.95 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $177.83 Median $239.88 Typical High $354.81 | Professional | None | $177.83 | $239.88 | $354.81 |
Ambetter Setting Professional Modifier None Typical Low $120.23 Median $169.82 Typical High $281.84 | Professional | None | $120.23 | $169.82 | $281.84 |
AvMed Setting Facility Modifier None Typical Low $338.84 Median $1,513.56 Typical High $9,549.93 | Facility | None | $338.84 | $1,513.56 | $9,549.93 |
AvMed Setting Professional Modifier None Typical Low $190.55 Median $257.04 Typical High $338.84 | Professional | None | $190.55 | $257.04 | $338.84 |
Cigna Setting Facility Modifier None Typical Low $380.19 Median $489.78 Typical High $2,187.76 | Facility | None | $380.19 | $489.78 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $223.87 Typical High $363.08 | Professional | None | $158.49 | $223.87 | $363.08 |
Florida Blue Setting Facility Modifier None Typical Low $363.08 Median $776.25 Typical High $4,466.84 | Facility | None | $363.08 | $776.25 | $4,466.84 |
Florida Blue Setting Professional Modifier None Typical Low $213.80 Median $234.42 Typical High $346.74 | Professional | None | $213.80 | $234.42 | $346.74 |
Molina Setting Professional Modifier None Typical Low $34.67 Median $239.88 Typical High $371.54 | Professional | None | $34.67 | $239.88 | $371.54 |
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 $141.25 Median $223.87 Typical High $398.11 | Professional | None | $141.25 | $223.87 | $398.11 |
Wellpoint Setting Professional Modifier None Typical Low $147.91 Median $239.88 Typical High $239.88 | Professional | None | $147.91 | $239.88 | $239.88 |
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 $85.11 Median $120.23 Typical High $134.90 | Professional | 52 · Reduced service | $85.11 | $120.23 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $47.86 Typical High $54.95 | Professional | 53 · Discontinued | $34.67 | $47.86 | $54.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $177.83 Typical High $204.17 | Professional | 54 · Surgery only | $128.82 | $177.83 | $204.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $35.48 Typical High $40.74 | Professional | 55 · Aftercare only | $25.70 | $35.48 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $23.99 Typical High $26.92 | Professional | 56 · Pre-op care only | $17.38 | $23.99 | $26.92 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $120.23 Median $165.96 Typical High $190.55 | Professional | 78 · Unplanned return to OR | $120.23 | $165.96 | $190.55 |
Ambetter Setting Professional Modifier 51 · Multiple procedures Typical Low $120.23 Median $141.25 Typical High $141.25 | Professional | 51 · Multiple procedures | $120.23 | $141.25 | $141.25 |
Ambetter Setting Professional Modifier 79 · Unrelated procedure after surgery Typical Low $141.25 Median $141.25 Typical High $141.25 | Professional | 79 · Unrelated procedure after surgery | $141.25 | $141.25 | $141.25 |
Where Florida sits
The same service costs 3.6 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· 44th of 51
$282
AK $851KY $234
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.