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 $380.19 Median $3,019.95 Typical High $10,964.78 | Facility | None | $380.19 | $3,019.95 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $141.25 Median $181.97 Typical High $263.03 | Professional | None | $141.25 | $181.97 | $263.03 |
Ambetter Setting Professional Modifier None Typical Low $104.71 Median $104.71 Typical High $177.83 | Professional | None | $104.71 | $104.71 | $177.83 |
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 $169.82 Median $194.98 Typical High $251.19 | Professional | None | $169.82 | $194.98 | $251.19 |
Cigna Setting Facility Modifier None Typical Low $141.25 Median $281.84 Typical High $1,659.59 | Facility | None | $141.25 | $281.84 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $131.83 Median $169.82 Typical High $281.84 | Professional | None | $131.83 | $169.82 | $281.84 |
Florida Blue Setting Facility Modifier None Typical Low $114.82 Median $251.19 Typical High $6,309.57 | Facility | None | $114.82 | $251.19 | $6,309.57 |
Florida Blue Setting Professional Modifier None Typical Low $158.49 Median $181.97 Typical High $257.04 | Professional | None | $158.49 | $181.97 | $257.04 |
Molina Setting Professional Modifier None Typical Low $128.82 Median $186.21 Typical High $269.15 | Professional | None | $128.82 | $186.21 | $269.15 |
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 $114.82 Median $169.82 Typical High $309.03 | Professional | None | $114.82 | $169.82 | $309.03 |
Wellpoint Setting Professional Modifier None Typical Low $125.89 Median $177.83 Typical High $177.83 | Professional | None | $125.89 | $177.83 | $177.83 |
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 $70.79 Median $85.11 Typical High $95.50 | Professional | 52 · Reduced service | $70.79 | $85.11 | $95.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $33.88 Typical High $38.90 | Professional | 53 · Discontinued | $28.18 | $33.88 | $38.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $104.71 Median $128.82 Typical High $144.54 | Professional | 54 · Surgery only | $104.71 | $128.82 | $144.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $25.70 Typical High $28.84 | Professional | 55 · Aftercare only | $20.89 | $25.70 | $28.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $16.98 Typical High $19.50 | Professional | 56 · Pre-op care only | $14.13 | $16.98 | $19.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $97.72 Median $120.23 Typical High $134.90 | Professional | 78 · Unplanned return to OR | $97.72 | $120.23 | $134.90 |
Where Florida sits
The same service costs 3.9 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
$191
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.