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 $141.25 Median $2,818.38 Typical High $10,964.78 | Facility | None | $141.25 | $2,818.38 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $79.43 Median $125.89 Typical High $251.19 | Professional | None | $79.43 | $125.89 | $251.19 |
Ambetter Setting Professional Modifier None Typical Low $144.54 Median $186.21 Typical High $295.12 | Professional | None | $144.54 | $186.21 | $295.12 |
AvMed Setting Facility Modifier None Typical Low $213.80 Median $2,137.96 Typical High $11,748.98 | Facility | None | $213.80 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $107.15 Median $194.98 Typical High $288.40 | Professional | None | $107.15 | $194.98 | $288.40 |
Cigna Setting Facility Modifier None Typical Low $52.48 Median $245.47 Typical High $478.63 | Facility | None | $52.48 | $245.47 | $478.63 |
Cigna Setting Professional Modifier None Typical Low $77.62 Median $173.78 Typical High $257.04 | Professional | None | $77.62 | $173.78 | $257.04 |
Florida Blue Setting Facility Modifier None Typical Low $64.57 Median $134.90 Typical High $4,466.84 | Facility | None | $64.57 | $134.90 | $4,466.84 |
Florida Blue Setting Professional Modifier None Typical Low $107.15 Median $186.21 Typical High $288.40 | Professional | None | $107.15 | $186.21 | $288.40 |
Molina Setting Professional Modifier None Typical Low $34.67 Median $208.93 Typical High $323.59 | Professional | None | $34.67 | $208.93 | $323.59 |
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 $67.61 Median $128.82 Typical High $234.42 | Professional | None | $67.61 | $128.82 | $234.42 |
Wellpoint Setting Professional Modifier None Typical Low $81.28 Median $208.93 Typical High $208.93 | Professional | None | $81.28 | $208.93 | $208.93 |
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 $38.90 Median $63.10 Typical High $75.86 | Professional | 52 · Reduced service | $38.90 | $63.10 | $75.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.49 Median $25.12 Typical High $30.20 | Professional | 53 · Discontinued | $15.49 | $25.12 | $30.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $57.54 Median $95.50 Typical High $114.82 | Professional | 54 · Surgery only | $57.54 | $95.50 | $114.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.75 Median $19.05 Typical High $22.91 | Professional | 55 · Aftercare only | $11.75 | $19.05 | $22.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.76 Median $12.59 Typical High $15.14 | Professional | 56 · Pre-op care only | $7.76 | $12.59 | $15.14 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $53.70 Median $89.13 Typical High $107.15 | Professional | 78 · Unplanned return to OR | $53.70 | $89.13 | $107.15 |
Where Florida sits
The same service costs 4.1 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· 47th of 51
$170
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.