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 $302.00 Median $2,951.21 Typical High $10,964.78 | Facility | None | $302.00 | $2,951.21 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $181.97 Median $223.87 Typical High $331.13 | Professional | None | $181.97 | $223.87 | $331.13 |
Ambetter Setting Professional Modifier None Typical Low $131.83 Median $131.83 Typical High $263.03 | Professional | None | $131.83 | $131.83 | $263.03 |
AvMed Setting Facility Modifier None Typical Low $302.00 Median $1,288.25 Typical High $9,549.93 | Facility | None | $302.00 | $1,288.25 | $9,549.93 |
AvMed Setting Professional Modifier None Typical Low $213.80 Median $251.19 Typical High $316.23 | Professional | None | $213.80 | $251.19 | $316.23 |
Cigna Setting Facility Modifier None Typical Low $323.59 Median $870.96 Typical High $1,659.59 | Facility | None | $323.59 | $870.96 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $208.93 Typical High $346.74 | Professional | None | $165.96 | $208.93 | $346.74 |
Florida Blue Setting Facility Modifier None Typical Low $380.19 Median $776.25 Typical High $6,309.57 | Facility | None | $380.19 | $776.25 | $6,309.57 |
Florida Blue Setting Professional Modifier None Typical Low $199.53 Median $229.09 Typical High $323.59 | Professional | None | $199.53 | $229.09 | $323.59 |
Molina Setting Professional Modifier None Typical Low $31.62 Median $213.80 Typical High $338.84 | Professional | None | $31.62 | $213.80 | $338.84 |
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 $147.91 Median $213.80 Typical High $389.05 | Professional | None | $147.91 | $213.80 | $389.05 |
Wellpoint Setting Professional Modifier None Typical Low $158.49 Median $223.87 Typical High $223.87 | Professional | None | $158.49 | $223.87 | $223.87 |
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 $91.20 Median $109.65 Typical High $123.03 | Professional | 52 · Reduced service | $91.20 | $109.65 | $123.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $43.65 Typical High $48.98 | Professional | 53 · Discontinued | $36.31 | $43.65 | $48.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $134.90 Median $162.18 Typical High $181.97 | Professional | 54 · Surgery only | $134.90 | $162.18 | $181.97 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $32.36 Typical High $36.31 | Professional | 55 · Aftercare only | $27.54 | $32.36 | $36.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $21.88 Typical High $24.55 | Professional | 56 · Pre-op care only | $18.20 | $21.88 | $24.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $125.89 Median $151.36 Typical High $169.82 | Professional | 78 · Unplanned return to OR | $125.89 | $151.36 | $169.82 |
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· 45th of 51
$263
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.