How much rates vary
Facilitymedian $302 · 10th to 90th $107 to $4,467Professionalmedian $204 · 10th to 90th $120 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 $208.93 Median $2,818.38 Typical High $10,715.19 | Facility | None | $208.93 | $2,818.38 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $144.54 Median $204.17 Typical High $323.59 | Professional | None | $144.54 | $204.17 | $323.59 |
Ambetter Setting Professional Modifier None Typical Low $125.89 Median $213.80 Typical High $281.84 | Professional | None | $125.89 | $213.80 | $281.84 |
AvMed Setting Facility Modifier None Typical Low $194.98 Median $2,137.96 Typical High $11,748.98 | Facility | None | $194.98 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $158.49 Median $234.42 Typical High $309.03 | Professional | None | $158.49 | $234.42 | $309.03 |
Cigna Setting Facility Modifier None Typical Low $52.48 Median $213.80 Typical High $426.58 | Facility | None | $52.48 | $213.80 | $426.58 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $199.53 Typical High $316.23 | Professional | None | $125.89 | $199.53 | $316.23 |
Florida Blue Setting Facility Modifier None Typical Low $120.23 Median $288.40 Typical High $3,890.45 | Facility | None | $120.23 | $288.40 | $3,890.45 |
Florida Blue Setting Professional Modifier None Typical Low $190.55 Median $208.93 Typical High $316.23 | Professional | None | $190.55 | $208.93 | $316.23 |
Molina Setting Professional Modifier None Typical Low $31.62 Median $213.80 Typical High $331.13 | Professional | None | $31.62 | $213.80 | $331.13 |
United Setting Facility Modifier None Typical Low $81.28 Median $302.00 Typical High $2,754.23 | Facility | None | $81.28 | $302.00 | $2,754.23 |
United Setting Professional Modifier None Typical Low $109.65 Median $186.21 Typical High $338.84 | Professional | None | $109.65 | $186.21 | $338.84 |
Wellpoint Setting Professional Modifier None Typical Low $117.49 Median $218.78 Typical High $218.78 | Professional | None | $117.49 | $218.78 | $218.78 |
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 $72.44 Median $100.00 Typical High $109.65 | Professional | 52 · Reduced service | $72.44 | $100.00 | $109.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $29.51 Median $40.74 Typical High $43.65 | Professional | 53 · Discontinued | $29.51 | $40.74 | $43.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $109.65 Median $151.36 Typical High $165.96 | Professional | 54 · Surgery only | $109.65 | $151.36 | $165.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $30.20 Typical High $33.11 | Professional | 55 · Aftercare only | $21.88 | $30.20 | $33.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $19.95 Typical High $21.88 | Professional | 56 · Pre-op care only | $14.45 | $19.95 | $21.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $102.33 Median $141.25 Typical High $154.88 | Professional | 78 · Unplanned return to OR | $102.33 | $141.25 | $154.88 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $213.80 Median $251.19 Typical High $251.19 | Professional | 59 · Distinct service | $213.80 | $251.19 | $251.19 |
Ambetter Setting Professional Modifier 79 · Unrelated procedure after surgery Typical Low $125.89 Median $125.89 Typical High $229.09 | Professional | 79 · Unrelated procedure after surgery | $125.89 | $125.89 | $229.09 |
Where Florida sits
The same service costs 3.4 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
$209
AK $692KY $204
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.