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 $91.20 Median $3,311.31 Typical High $12,022.64 | Facility | None | $91.20 | $3,311.31 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $72.44 Median $91.20 Typical High $151.36 | Professional | None | $72.44 | $91.20 | $151.36 |
Ambetter Setting Professional Modifier None Typical Low $131.83 Median $131.83 Typical High $162.18 | Professional | None | $131.83 | $131.83 | $162.18 |
AvMed Setting Facility Modifier None Typical Low $93.33 Median $2,137.96 Typical High $11,748.98 | Facility | None | $93.33 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $85.11 Median $100.00 Typical High $125.89 | Professional | None | $85.11 | $100.00 | $125.89 |
Cigna Setting Facility Modifier None Typical Low $79.43 Median $158.49 Typical High $1,659.59 | Facility | None | $79.43 | $158.49 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $63.10 Median $97.72 Typical High $190.55 | Professional | None | $63.10 | $97.72 | $190.55 |
Florida Blue Setting Facility Modifier None Typical Low $60.26 Median $131.83 Typical High $3,019.95 | Facility | None | $60.26 | $131.83 | $3,019.95 |
Florida Blue Setting Professional Modifier None Typical Low $79.43 Median $89.13 Typical High $120.23 | Professional | None | $79.43 | $89.13 | $120.23 |
Molina Setting Professional Modifier None Typical Low $77.62 Median $107.15 Typical High $208.93 | Professional | None | $77.62 | $107.15 | $208.93 |
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 $66.07 Median $109.65 Typical High $208.93 | Professional | None | $66.07 | $109.65 | $208.93 |
Wellpoint Setting Professional Modifier None Typical Low $64.57 Median $93.33 Typical High $93.33 | Professional | None | $64.57 | $93.33 | $93.33 |
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 $36.31 Median $45.71 Typical High $57.54 | Professional | 52 · Reduced service | $36.31 | $45.71 | $57.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.45 Median $18.20 Typical High $22.91 | Professional | 53 · Discontinued | $14.45 | $18.20 | $22.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $53.70 Median $69.18 Typical High $85.11 | Professional | 54 · Surgery only | $53.70 | $69.18 | $85.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.72 Median $13.80 Typical High $17.38 | Professional | 55 · Aftercare only | $10.72 | $13.80 | $17.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.24 Median $9.12 Typical High $11.48 | Professional | 56 · Pre-op care only | $7.24 | $9.12 | $11.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $50.12 Median $64.57 Typical High $79.43 | Professional | 78 · Unplanned return to OR | $50.12 | $64.57 | $79.43 |
Ambetter Setting Professional Modifier 58 · Staged procedure Typical Low $97.72 Median $114.82 Typical High $131.83 | Professional | 58 · Staged procedure | $97.72 | $114.82 | $131.83 |
Where Florida sits
The same service costs 3.3 times more in Alaska than in Pennsylvania. 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· 50th of 51
$107
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.