How much rates vary
Facilitymedian $933 · 10th to 90th $372 to $6,026Professionalmedian $234 · 10th to 90th $47 to $457
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 $354.81 Median $3,019.95 Typical High $10,964.78 | Facility | None | $354.81 | $3,019.95 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $181.97 Median $229.09 Typical High $346.74 | Professional | None | $181.97 | $229.09 | $346.74 |
Ambetter Setting Professional Modifier None Typical Low $263.03 Median $263.03 Typical High $263.03 | Professional | None | $263.03 | $263.03 | $263.03 |
AvMed Setting Facility Modifier None Typical Low $288.40 Median $1,288.25 Typical High $9,549.93 | Facility | None | $288.40 | $1,288.25 | $9,549.93 |
AvMed Setting Professional Modifier None Typical Low $199.53 Median $239.88 Typical High $302.00 | Professional | None | $199.53 | $239.88 | $302.00 |
Cigna Setting Facility Modifier None Typical Low $323.59 Median $776.25 Typical High $1,659.59 | Facility | None | $323.59 | $776.25 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $144.54 Median $239.88 Typical High $467.74 | Professional | None | $144.54 | $239.88 | $467.74 |
Florida Blue Setting Facility Modifier None Typical Low $380.19 Median $776.25 Typical High $6,309.57 | Facility | None | $380.19 | $776.25 | $6,309.57 |
Florida Blue Setting Professional Modifier None Typical Low $190.55 Median $204.17 Typical High $281.84 | Professional | None | $190.55 | $204.17 | $281.84 |
Molina Setting Professional Modifier None Typical Low $31.62 Median $223.87 Typical High $478.63 | Professional | None | $31.62 | $223.87 | $478.63 |
United Setting Facility Modifier None Typical Low $398.11 Median $1,000.00 Typical High $5,623.41 | Facility | None | $398.11 | $1,000.00 | $5,623.41 |
United Setting Professional Modifier None Typical Low $169.82 Median $275.42 Typical High $549.54 | Professional | None | $169.82 | $275.42 | $549.54 |
Wellpoint Setting Professional Modifier None Typical Low $147.91 Median $213.80 Typical High $213.80 | Professional | None | $147.91 | $213.80 | $213.80 |
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 $91.20 Median $114.82 Typical High $147.91 | Professional | 52 · Reduced service | $91.20 | $114.82 | $147.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $45.71 Typical High $58.88 | Professional | 53 · Discontinued | $36.31 | $45.71 | $58.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $173.78 Typical High $218.78 | Professional | 54 · Surgery only | $138.04 | $173.78 | $218.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $34.67 Typical High $43.65 | Professional | 55 · Aftercare only | $27.54 | $34.67 | $43.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $22.91 Typical High $29.51 | Professional | 56 · Pre-op care only | $18.20 | $22.91 | $29.51 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $128.82 Median $162.18 Typical High $204.17 | Professional | 78 · Unplanned return to OR | $128.82 | $162.18 | $204.17 |
Ambetter Setting Professional Modifier 79 · Unrelated procedure after surgery Typical Low $173.78 Median $173.78 Typical High $173.78 | Professional | 79 · Unrelated procedure after surgery | $173.78 | $173.78 | $173.78 |
Where Florida sits
The same service costs 4.3 times more in Alaska 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· 43rd of 51
$295
AK $1,000UT $234
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.