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 $47.86 Median $2,818.38 Typical High $10,964.78 | Facility | None | $47.86 | $2,818.38 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $25.70 Median $43.65 Typical High $64.57 | Professional | None | $25.70 | $43.65 | $64.57 |
Ambetter Setting Professional Modifier None Typical Low $43.65 Median $51.29 Typical High $56.23 | Professional | None | $43.65 | $51.29 | $56.23 |
AvMed Setting Facility Modifier None Typical Low $46.77 Median $2,137.96 Typical High $11,748.98 | Facility | None | $46.77 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $25.70 Median $46.77 Typical High $60.26 | Professional | None | $25.70 | $46.77 | $60.26 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $66.07 Typical High $724.44 | Facility | None | $50.12 | $66.07 | $724.44 |
Cigna Setting Professional Modifier None Typical Low $22.39 Median $39.81 Typical High $61.66 | Professional | None | $22.39 | $39.81 | $61.66 |
Florida Blue Setting Facility Modifier None Typical Low $34.67 Median $74.13 Typical High $3,019.95 | Facility | None | $34.67 | $74.13 | $3,019.95 |
Florida Blue Setting Professional Modifier None Typical Low $38.90 Median $42.66 Typical High $61.66 | Professional | None | $38.90 | $42.66 | $61.66 |
Molina Setting Professional Modifier None Typical Low $22.39 Median $54.95 Typical High $85.11 | Professional | None | $22.39 | $54.95 | $85.11 |
United Setting Facility Modifier None Typical Low $81.28 Median $302.00 Typical High $2,818.38 | Facility | None | $81.28 | $302.00 | $2,818.38 |
United Setting Professional Modifier None Typical Low $21.88 Median $38.90 Typical High $66.07 | Professional | None | $21.88 | $38.90 | $66.07 |
Wellpoint Setting Professional Modifier None Typical Low $20.42 Median $44.67 Typical High $44.67 | Professional | None | $20.42 | $44.67 | $44.67 |
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 $12.88 Median $21.38 Typical High $23.99 | Professional | 52 · Reduced service | $12.88 | $21.38 | $23.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.25 Median $8.51 Typical High $9.55 | Professional | 53 · Discontinued | $5.25 | $8.51 | $9.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $19.50 Median $32.36 Typical High $35.48 | Professional | 54 · Surgery only | $19.50 | $32.36 | $35.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.89 Median $6.46 Typical High $7.08 | Professional | 55 · Aftercare only | $3.89 | $6.46 | $7.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.57 Median $4.27 Typical High $4.79 | Professional | 56 · Pre-op care only | $2.57 | $4.27 | $4.79 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $43.65 Median $43.65 Typical High $61.66 | Professional | 59 · Distinct service | $43.65 | $43.65 | $61.66 |
Ambetter Setting Professional Modifier 79 · Unrelated procedure after surgery Typical Low $51.29 Median $51.29 Typical High $56.23 | Professional | 79 · Unrelated procedure after surgery | $51.29 | $51.29 | $56.23 |
Where Florida sits
The same service costs 3.5 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· 48th of 51
$47.86
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.