How much rates vary
Facilitymedian $135 · 10th to 90th $37 to $3,548Professionalmedian $52 · 10th to 90th $34 to $83
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 $52.48 Median $1,737.80 Typical High $10,471.29 | Facility | None | $52.48 | $1,737.80 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $40.74 Median $52.48 Typical High $83.18 | Professional | None | $40.74 | $52.48 | $83.18 |
Ambetter Setting Professional Modifier None Typical Low $22.39 Median $61.66 Typical High $79.43 | Professional | None | $22.39 | $61.66 | $79.43 |
AvMed Setting Facility Modifier None Typical Low $58.88 Median $1,698.24 Typical High $9,772.37 | Facility | None | $58.88 | $1,698.24 | $9,772.37 |
AvMed Setting Professional Modifier None Typical Low $43.65 Median $58.88 Typical High $77.62 | Professional | None | $43.65 | $58.88 | $77.62 |
Cigna Setting Facility Modifier None Typical Low $38.02 Median $75.86 Typical High $1,659.59 | Facility | None | $38.02 | $75.86 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $32.36 Median $46.77 Typical High $83.18 | Professional | None | $32.36 | $46.77 | $83.18 |
Florida Blue Setting Facility Modifier None Typical Low $32.36 Median $69.18 Typical High $3,019.95 | Facility | None | $32.36 | $69.18 | $3,019.95 |
Florida Blue Setting Professional Modifier None Typical Low $30.20 Median $67.61 Typical High $100.00 | Professional | None | $30.20 | $67.61 | $100.00 |
Molina Setting Professional Modifier None Typical Low $34.67 Median $56.23 Typical High $97.72 | Professional | None | $34.67 | $56.23 | $97.72 |
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 $33.88 Median $47.86 Typical High $95.50 | Professional | None | $33.88 | $47.86 | $95.50 |
Wellpoint Setting Professional Modifier None Typical Low $30.90 Median $53.70 Typical High $53.70 | Professional | None | $30.90 | $53.70 | $53.70 |
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 $20.42 Median $26.30 Typical High $30.90 | Professional | 52 · Reduced service | $20.42 | $26.30 | $30.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.13 Median $10.47 Typical High $12.30 | Professional | 53 · Discontinued | $8.13 | $10.47 | $12.30 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $30.90 Median $38.90 Typical High $45.71 | Professional | 54 · Surgery only | $30.90 | $38.90 | $45.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.17 Median $7.76 Typical High $9.12 | Professional | 55 · Aftercare only | $6.17 | $7.76 | $9.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.07 Median $5.25 Typical High $6.17 | Professional | 56 · Pre-op care only | $4.07 | $5.25 | $6.17 |
Ambetter Setting Professional Modifier 50 · Both sides Typical Low $83.18 Median $97.72 Typical High $109.65 | Professional | 50 · Both sides | $83.18 | $97.72 | $109.65 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $66.07 Median $66.07 Typical High $66.07 | Professional | 59 · Distinct service | $66.07 | $66.07 | $66.07 |
Ambetter Setting Professional Modifier 79 · Unrelated procedure after surgery Typical Low $72.44 Median $72.44 Typical High $72.44 | Professional | 79 · Unrelated procedure after surgery | $72.44 | $72.44 | $72.44 |
Where Florida sits
The same service costs 4.2 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
$53.70
AK $224FL $53.70
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.