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 $363.08 Median $3,311.31 Typical High $10,964.78 | Facility | None | $363.08 | $3,311.31 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $263.03 Median $316.23 Typical High $457.09 | Professional | None | $263.03 | $316.23 | $457.09 |
Ambetter Setting Professional Modifier None Typical Low $181.97 Median $181.97 Typical High $380.19 | Professional | None | $181.97 | $181.97 | $380.19 |
AvMed Setting Facility Modifier None Typical Low $416.87 Median $1,479.11 Typical High $9,549.93 | Facility | None | $416.87 | $1,479.11 | $9,549.93 |
AvMed Setting Professional Modifier None Typical Low $302.00 Median $346.74 Typical High $446.68 | Professional | None | $302.00 | $346.74 | $446.68 |
Cigna Setting Facility Modifier None Typical Low $436.52 Median $1,445.44 Typical High $2,344.23 | Facility | None | $436.52 | $1,445.44 | $2,344.23 |
Cigna Setting Professional Modifier None Typical Low $234.42 Median $281.84 Typical High $489.78 | Professional | None | $234.42 | $281.84 | $489.78 |
Florida Blue Setting Facility Modifier None Typical Low $977.24 Median $1,995.26 Typical High $11,748.98 | Facility | None | $977.24 | $1,995.26 | $11,748.98 |
Florida Blue Setting Professional Modifier None Typical Low $281.84 Median $316.23 Typical High $457.09 | Professional | None | $281.84 | $316.23 | $457.09 |
Molina Setting Professional Modifier None Typical Low $34.67 Median $354.81 Typical High $524.81 | Professional | None | $34.67 | $354.81 | $524.81 |
United Setting Facility Modifier None Typical Low $794.33 Median $1,778.28 Typical High $7,585.78 | Facility | None | $794.33 | $1,778.28 | $7,585.78 |
United Setting Professional Modifier None Typical Low $213.80 Median $302.00 Typical High $549.54 | Professional | None | $213.80 | $302.00 | $549.54 |
Wellpoint Setting Professional Modifier None Typical Low $223.87 Median $309.03 Typical High $309.03 | Professional | None | $223.87 | $309.03 | $309.03 |
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 $128.82 Median $151.36 Typical High $169.82 | Professional | 52 · Reduced service | $128.82 | $151.36 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $52.48 Median $60.26 Typical High $67.61 | Professional | 53 · Discontinued | $52.48 | $60.26 | $67.61 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $194.98 Median $223.87 Typical High $257.04 | Professional | 54 · Surgery only | $194.98 | $223.87 | $257.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $44.67 Typical High $51.29 | Professional | 55 · Aftercare only | $38.90 | $44.67 | $51.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $30.20 Typical High $33.88 | Professional | 56 · Pre-op care only | $25.70 | $30.20 | $33.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $181.97 Median $208.93 Typical High $239.88 | Professional | 78 · Unplanned return to OR | $181.97 | $208.93 | $239.88 |
Where Florida sits
The same service costs 4.5 times more in Alaska than in New Jersey. 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· 37th of 51
$389
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.