How much rates vary
Facilitymedian $2,692 · 10th to 90th $186 to $9,772Professionalmedian $123 · 10th to 90th $60 to $282
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 $186.21 Median $2,884.03 Typical High $10,964.78 | Facility | None | $186.21 | $2,884.03 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $69.18 Median $165.96 Typical High $245.47 | Professional | None | $69.18 | $165.96 | $245.47 |
Ambetter Setting Professional Modifier None Typical Low $61.66 Median $64.57 Typical High $162.18 | Professional | None | $61.66 | $64.57 | $162.18 |
AvMed Setting Facility Modifier None Typical Low $151.36 Median $6,025.60 Typical High $13,182.57 | Facility | None | $151.36 | $6,025.60 | $13,182.57 |
AvMed Setting Professional Modifier None Typical Low $70.79 Median $144.54 Typical High $190.55 | Professional | None | $70.79 | $144.54 | $190.55 |
Cigna Setting Facility Modifier None Typical Low $112.20 Median $112.20 Typical High $323.59 | Facility | None | $112.20 | $112.20 | $323.59 |
Cigna Setting Professional Modifier None Typical Low $53.70 Median $123.03 Typical High $288.40 | Professional | None | $53.70 | $123.03 | $288.40 |
Florida Blue Setting Facility Modifier None Typical Low $1,348.96 Median $2,691.53 Typical High $6,309.57 | Facility | None | $1,348.96 | $2,691.53 | $6,309.57 |
Florida Blue Setting Professional Modifier None Typical Low $117.49 Median $229.09 Typical High $281.84 | Professional | None | $117.49 | $229.09 | $281.84 |
Molina Setting Professional Modifier None Typical Low $77.62 Median $107.15 Typical High $288.40 | Professional | None | $77.62 | $107.15 | $288.40 |
United Setting Facility Modifier None Typical Low $169.82 Median $1,819.70 Typical High $5,248.07 | Facility | None | $169.82 | $1,819.70 | $5,248.07 |
United Setting Professional Modifier None Typical Low $66.07 Median $154.88 Typical High $323.59 | Professional | None | $66.07 | $154.88 | $323.59 |
Wellpoint Setting Professional Modifier None Typical Low $48.98 Median $131.83 Typical High $131.83 | Professional | None | $48.98 | $131.83 | $131.83 |
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 $33.88 Median $77.62 Typical High $104.71 | Professional | 52 · Reduced service | $33.88 | $77.62 | $104.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $30.90 Typical High $41.69 | Professional | 53 · Discontinued | $13.80 | $30.90 | $41.69 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $51.29 Median $114.82 Typical High $158.49 | Professional | 54 · Surgery only | $51.29 | $114.82 | $158.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $22.91 Typical High $31.62 | Professional | 55 · Aftercare only | $10.23 | $22.91 | $31.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $15.49 Typical High $20.89 | Professional | 56 · Pre-op care only | $6.92 | $15.49 | $20.89 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $158.49 Median $158.49 Typical High $158.49 | Professional | 59 · Distinct service | $158.49 | $158.49 | $158.49 |
Ambetter Setting Professional Modifier Q6 · Substitute physician, paid per time Typical Low $158.49 Median $158.49 Typical High $158.49 | Professional | Q6 · Substitute physician, paid per time | $158.49 | $158.49 | $158.49 |
Ambetter Setting Professional Modifier XS · Separate structure Typical Low $158.49 Median $158.49 Typical High $158.49 | Professional | XS · Separate structure | $158.49 | $158.49 | $158.49 |
Where Florida sits
The same service costs 2.7 times more in Wisconsin than in Utah. 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
$126
WI $316UT $117
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.