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 $147.91 Median $1,659.59 Typical High $10,471.29 | Facility | None | $147.91 | $1,659.59 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $141.25 Median $177.83 Typical High $269.15 | Professional | None | $141.25 | $177.83 | $269.15 |
Ambetter Setting Professional Modifier None Typical Low $134.90 Median $177.83 Typical High $234.42 | Professional | None | $134.90 | $177.83 | $234.42 |
AvMed Setting Facility Modifier None Typical Low $177.83 Median $2,137.96 Typical High $11,748.98 | Facility | None | $177.83 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $173.78 Median $194.98 Typical High $239.88 | Professional | None | $173.78 | $194.98 | $239.88 |
Cigna Setting Facility Modifier None Typical Low $128.82 Median $257.04 Typical High $1,659.59 | Facility | None | $128.82 | $257.04 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $134.90 Median $158.49 Typical High $269.15 | Professional | None | $134.90 | $158.49 | $269.15 |
Florida Blue Setting Facility Modifier None Typical Low $64.57 Median $128.82 Typical High $3,890.45 | Facility | None | $64.57 | $128.82 | $3,890.45 |
Florida Blue Setting Professional Modifier None Typical Low $154.88 Median $165.96 Typical High $245.47 | Professional | None | $154.88 | $165.96 | $245.47 |
Molina Setting Professional Modifier None Typical Low $134.90 Median $186.21 Typical High $257.04 | Professional | None | $134.90 | $186.21 | $257.04 |
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 $120.23 Median $162.18 Typical High $302.00 | Professional | None | $120.23 | $162.18 | $302.00 |
Wellpoint Setting Professional Modifier None Typical Low $134.90 Median $169.82 Typical High $169.82 | Professional | None | $134.90 | $169.82 | $169.82 |
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 $64.57 Median $77.62 Typical High $91.20 | Professional | 52 · Reduced service | $64.57 | $77.62 | $91.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $30.90 Typical High $37.15 | Professional | 53 · Discontinued | $25.70 | $30.90 | $37.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $97.72 Median $117.49 Typical High $138.04 | Professional | 54 · Surgery only | $97.72 | $117.49 | $138.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $23.44 Typical High $27.54 | Professional | 55 · Aftercare only | $19.50 | $23.44 | $27.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $15.49 Typical High $18.62 | Professional | 56 · Pre-op care only | $12.88 | $15.49 | $18.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $91.20 Median $109.65 Typical High $128.82 | Professional | 78 · Unplanned return to OR | $91.20 | $109.65 | $128.82 |
Where Florida sits
The same service costs 4.4 times more in Alaska than in Florida. 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· 51st of 51
$174
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.