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 $776.25 Median $4,677.35 Typical High $11,748.98 | Facility | None | $776.25 | $4,677.35 | $11,748.98 |
Aetna Setting Professional Modifier None Typical Low $1,148.15 Median $1,380.38 Typical High $1,584.89 | Professional | None | $1,148.15 | $1,380.38 | $1,584.89 |
AvMed Setting Facility Modifier None Typical Low $912.01 Median $2,137.96 Typical High $9,772.37 | Facility | None | $912.01 | $2,137.96 | $9,772.37 |
AvMed Setting Professional Modifier None Typical Low $1,023.29 Median $1,348.96 Typical High $1,584.89 | Professional | None | $1,023.29 | $1,348.96 | $1,584.89 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $3,890.45 Typical High $7,413.10 | Facility | None | $501.19 | $3,890.45 | $7,413.10 |
Cigna Setting Professional Modifier None Typical Low $1,000.00 Median $1,047.13 Typical High $2,187.76 | Professional | None | $1,000.00 | $1,047.13 | $2,187.76 |
Florida Blue Setting Facility Modifier None Typical Low $1,318.26 Median $2,630.27 Typical High $16,982.44 | Facility | None | $1,318.26 | $2,630.27 | $16,982.44 |
Florida Blue Setting Professional Modifier None Typical Low $588.84 Median $1,230.27 Typical High $1,445.44 | Professional | None | $588.84 | $1,230.27 | $1,445.44 |
Molina Setting Professional Modifier None Typical Low $91.20 Median $891.25 Typical High $1,513.56 | Professional | None | $91.20 | $891.25 | $1,513.56 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $3,311.31 Typical High $12,589.25 | Facility | None | $1,230.27 | $3,311.31 | $12,589.25 |
United Setting Professional Modifier None Typical Low $912.01 Median $1,202.26 Typical High $2,344.23 | Professional | None | $912.01 | $1,202.26 | $2,344.23 |
Wellpoint Setting Professional Modifier None Typical Low $954.99 Median $954.99 Typical High $1,288.25 | Professional | None | $954.99 | $954.99 | $1,288.25 |
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 $575.44 Median $691.83 Typical High $776.25 | Professional | 52 · Reduced service | $575.44 | $691.83 | $776.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $229.09 Median $275.42 Typical High $309.03 | Professional | 53 · Discontinued | $229.09 | $275.42 | $309.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $851.14 Median $1,047.13 Typical High $1,174.90 | Professional | 54 · Surgery only | $851.14 | $1,047.13 | $1,174.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $169.82 Median $208.93 Typical High $234.42 | Professional | 55 · Aftercare only | $169.82 | $208.93 | $234.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $138.04 Typical High $154.88 | Professional | 56 · Pre-op care only | $114.82 | $138.04 | $154.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $794.33 Median $977.24 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $794.33 | $977.24 | $1,096.48 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $2,630.27 Median $2,630.27 Typical High $2,630.27 | Professional | 59 · Distinct service | $2,630.27 | $2,630.27 | $2,630.27 |
Where Florida sits
The same service costs 7.2 times more in Alaska than in Texas. 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· 47th of 51
$1,148
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.