How much rates vary
Facilitymedian $501 · 10th to 90th $224 to $4,786Professionalmedian $209 · 10th to 90th $126 to $355
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 $218.78 Median $2,818.38 Typical High $10,964.78 | Facility | None | $218.78 | $2,818.38 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $158.49 Median $218.78 Typical High $331.13 | Professional | None | $158.49 | $218.78 | $331.13 |
Ambetter Setting Professional Modifier None Typical Low $181.97 Median $251.19 Typical High $309.03 | Professional | None | $181.97 | $251.19 | $309.03 |
AvMed Setting Facility Modifier None Typical Low $234.42 Median $2,137.96 Typical High $11,748.98 | Facility | None | $234.42 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $186.21 Median $257.04 Typical High $338.84 | Professional | None | $186.21 | $257.04 | $338.84 |
Cigna Setting Facility Modifier None Typical Low $234.42 Median $331.13 Typical High $1,659.59 | Facility | None | $234.42 | $331.13 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $134.90 Median $199.53 Typical High $323.59 | Professional | None | $134.90 | $199.53 | $323.59 |
Florida Blue Setting Facility Modifier None Typical Low $199.53 Median $436.52 Typical High $4,466.84 | Facility | None | $199.53 | $436.52 | $4,466.84 |
Florida Blue Setting Professional Modifier None Typical Low $109.65 Median $173.78 Typical High $371.54 | Professional | None | $109.65 | $173.78 | $371.54 |
Molina Setting Professional Modifier None Typical Low $26.92 Median $218.78 Typical High $537.03 | Professional | None | $26.92 | $218.78 | $537.03 |
United Setting Facility Modifier None Typical Low $281.84 Median $660.69 Typical High $4,073.80 | Facility | None | $281.84 | $660.69 | $4,073.80 |
United Setting Professional Modifier None Typical Low $134.90 Median $194.98 Typical High $323.59 | Professional | None | $134.90 | $194.98 | $323.59 |
Wellpoint Setting Professional Modifier None Typical Low $154.88 Median $239.88 Typical High $239.88 | Professional | None | $154.88 | $239.88 | $239.88 |
9 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 $72.44 Median $95.50 Typical High $131.83 | Professional | 52 · Reduced service | $72.44 | $95.50 | $131.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $29.51 Median $38.90 Typical High $52.48 | Professional | 53 · Discontinued | $29.51 | $38.90 | $52.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $109.65 Median $144.54 Typical High $194.98 | Professional | 54 · Surgery only | $109.65 | $144.54 | $194.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $28.84 Typical High $38.90 | Professional | 55 · Aftercare only | $21.88 | $28.84 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $19.05 Typical High $26.30 | Professional | 56 · Pre-op care only | $14.45 | $19.05 | $26.30 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $102.33 Median $134.90 Typical High $181.97 | Professional | 78 · Unplanned return to OR | $102.33 | $134.90 | $181.97 |
Ambetter Setting Professional Modifier 51 · Multiple procedures Typical Low $104.71 Median $181.97 Typical High $181.97 | Professional | 51 · Multiple procedures | $104.71 | $181.97 | $181.97 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $181.97 Median $295.12 Typical High $295.12 | Professional | 59 · Distinct service | $181.97 | $295.12 | $295.12 |
Ambetter Setting Professional Modifier 78 · Unplanned return to OR Typical Low $295.12 Median $295.12 Typical High $295.12 | Professional | 78 · Unplanned return to OR | $295.12 | $295.12 | $295.12 |
Where Florida sits
The same service costs 3.8 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
$214
AK $776KY $204
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.