How much rates vary
Facilitymedian $380 · 10th to 90th $120 to $4,786Professionalmedian $324 · 10th to 90th $182 to $490
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 $338.84 Median $2,951.21 Typical High $11,481.54 | Facility | None | $338.84 | $2,951.21 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $234.42 Median $338.84 Typical High $501.19 | Professional | None | $234.42 | $338.84 | $501.19 |
Ambetter Setting Professional Modifier None Typical Low $213.80 Median $338.84 Typical High $398.11 | Professional | None | $213.80 | $338.84 | $398.11 |
AvMed Setting Facility Modifier None Typical Low $208.93 Median $954.99 Typical High $9,549.93 | Facility | None | $208.93 | $954.99 | $9,549.93 |
AvMed Setting Professional Modifier None Typical Low $229.09 Median $346.74 Typical High $446.68 | Professional | None | $229.09 | $346.74 | $446.68 |
Cigna Setting Facility Modifier None Typical Low $218.78 Median $457.09 Typical High $2,691.53 | Facility | None | $218.78 | $457.09 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $190.55 Median $302.00 Typical High $489.78 | Professional | None | $190.55 | $302.00 | $489.78 |
Florida Blue Setting Facility Modifier None Typical Low $125.89 Median $316.23 Typical High $5,011.87 | Facility | None | $125.89 | $316.23 | $5,011.87 |
Florida Blue Setting Professional Modifier None Typical Low $288.40 Median $316.23 Typical High $467.74 | Professional | None | $288.40 | $316.23 | $467.74 |
Molina Setting Professional Modifier None Typical Low $34.67 Median $323.59 Typical High $501.19 | Professional | None | $34.67 | $323.59 | $501.19 |
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 $169.82 Median $302.00 Typical High $537.03 | Professional | None | $169.82 | $302.00 | $537.03 |
Wellpoint Setting Professional Modifier None Typical Low $177.83 Median $323.59 Typical High $323.59 | Professional | None | $177.83 | $323.59 | $323.59 |
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 $112.20 Median $169.82 Typical High $181.97 | Professional | 52 · Reduced service | $112.20 | $169.82 | $181.97 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $44.67 Median $67.61 Typical High $72.44 | Professional | 53 · Discontinued | $44.67 | $67.61 | $72.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $165.96 Median $251.19 Typical High $275.42 | Professional | 54 · Surgery only | $165.96 | $251.19 | $275.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $50.12 Typical High $54.95 | Professional | 55 · Aftercare only | $33.88 | $50.12 | $54.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.39 Median $33.88 Typical High $36.31 | Professional | 56 · Pre-op care only | $22.39 | $33.88 | $36.31 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $154.88 Median $234.42 Typical High $257.04 | Professional | 78 · Unplanned return to OR | $154.88 | $234.42 | $257.04 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $316.23 Median $380.19 Typical High $416.87 | Professional | 59 · Distinct service | $316.23 | $380.19 | $416.87 |
Ambetter Setting Professional Modifier 79 · Unrelated procedure after surgery Typical Low $186.21 Median $316.23 Typical High $380.19 | Professional | 79 · Unrelated procedure after surgery | $186.21 | $316.23 | $380.19 |
Where Florida sits
The same service costs 3.2 times more in Alaska than in Florida. 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· 51st of 51
$324
AK $1,047FL $324
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.