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 $89.13 Median $2,818.38 Typical High $10,964.78 | Facility | None | $89.13 | $2,818.38 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $53.70 Median $83.18 Typical High $125.89 | Professional | None | $53.70 | $83.18 | $125.89 |
Ambetter Setting Professional Modifier None Typical Low $83.18 Median $97.72 Typical High $114.82 | Professional | None | $83.18 | $97.72 | $114.82 |
AvMed Setting Facility Modifier None Typical Low $91.20 Median $2,137.96 Typical High $11,748.98 | Facility | None | $91.20 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $61.66 Median $91.20 Typical High $117.49 | Professional | None | $61.66 | $91.20 | $117.49 |
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 $48.98 Median $77.62 Typical High $123.03 | Professional | None | $48.98 | $77.62 | $123.03 |
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 $57.54 Median $81.28 Typical High $120.23 | Professional | None | $57.54 | $81.28 | $120.23 |
Molina Setting Professional Modifier None Typical Low $72.44 Median $107.15 Typical High $165.96 | Professional | None | $72.44 | $107.15 | $165.96 |
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 $46.77 Median $75.86 Typical High $138.04 | Professional | None | $46.77 | $75.86 | $138.04 |
Wellpoint Setting Professional Modifier None Typical Low $48.98 Median $87.10 Typical High $87.10 | Professional | None | $48.98 | $87.10 | $87.10 |
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 $26.30 Median $40.74 Typical High $46.77 | Professional | 52 · Reduced service | $26.30 | $40.74 | $46.77 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.72 Median $16.60 Typical High $18.62 | Professional | 53 · Discontinued | $10.72 | $16.60 | $18.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $39.81 Median $61.66 Typical High $70.79 | Professional | 54 · Surgery only | $39.81 | $61.66 | $70.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.94 Median $12.30 Typical High $14.13 | Professional | 55 · Aftercare only | $7.94 | $12.30 | $14.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.37 Median $8.13 Typical High $9.33 | Professional | 56 · Pre-op care only | $5.37 | $8.13 | $9.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $37.15 Median $57.54 Typical High $66.07 | Professional | 78 · Unplanned return to OR | $37.15 | $57.54 | $66.07 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $83.18 Median $93.33 Typical High $109.65 | Professional | 59 · Distinct service | $83.18 | $93.33 | $109.65 |
Where Florida sits
The same service costs 3.9 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· 49th of 51
$87.10
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.