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 $83.18 Median $1,318.26 Typical High $9,332.54 | Facility | None | $83.18 | $1,318.26 | $9,332.54 |
Aetna Setting Professional Modifier None Typical Low $77.62 Median $100.00 Typical High $158.49 | Professional | None | $77.62 | $100.00 | $158.49 |
Ambetter Setting Professional Modifier None Typical Low $91.20 Median $107.15 Typical High $125.89 | Professional | None | $91.20 | $107.15 | $125.89 |
AvMed Setting Facility Modifier None Typical Low $109.65 Median $1,513.56 Typical High $9,772.37 | Facility | None | $109.65 | $1,513.56 | $9,772.37 |
AvMed Setting Professional Modifier None Typical Low $97.72 Median $109.65 Typical High $138.04 | Professional | None | $97.72 | $109.65 | $138.04 |
Cigna Setting Facility Modifier None Typical Low $52.48 Median $93.33 Typical High $181.97 | Facility | None | $52.48 | $93.33 | $181.97 |
Cigna Setting Professional Modifier None Typical Low $77.62 Median $91.20 Typical High $151.36 | Professional | None | $77.62 | $91.20 | $151.36 |
Florida Blue Setting Facility Modifier None Typical Low $60.26 Median $128.82 Typical High $3,019.95 | Facility | None | $60.26 | $128.82 | $3,019.95 |
Florida Blue Setting Professional Modifier None Typical Low $87.10 Median $95.50 Typical High $141.25 | Professional | None | $87.10 | $95.50 | $141.25 |
Molina Setting Professional Modifier None Typical Low $77.62 Median $117.49 Typical High $169.82 | Professional | None | $77.62 | $117.49 | $169.82 |
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 $64.57 Median $91.20 Typical High $165.96 | Professional | None | $64.57 | $91.20 | $165.96 |
Wellpoint Setting Professional Modifier None Typical Low $77.62 Median $100.00 Typical High $100.00 | Professional | None | $77.62 | $100.00 | $100.00 |
6 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 $42.66 Typical High $51.29 | Professional | 52 · Reduced service | $36.31 | $42.66 | $51.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.45 Median $16.98 Typical High $20.42 | Professional | 53 · Discontinued | $14.45 | $16.98 | $20.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $54.95 Median $63.10 Typical High $77.62 | Professional | 54 · Surgery only | $54.95 | $63.10 | $77.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.96 Median $12.59 Typical High $15.49 | Professional | 55 · Aftercare only | $10.96 | $12.59 | $15.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.24 Median $8.51 Typical High $10.23 | Professional | 56 · Pre-op care only | $7.24 | $8.51 | $10.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $51.29 Median $58.88 Typical High $72.44 | Professional | 78 · Unplanned return to OR | $51.29 | $58.88 | $72.44 |
Where Florida sits
The same service costs 4.4 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
$105
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.