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 $354.81 Median $3,019.95 Typical High $10,964.78 | Facility | None | $354.81 | $3,019.95 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $173.78 Median $229.09 Typical High $346.74 | Professional | None | $173.78 | $229.09 | $346.74 |
Ambetter Setting Professional Modifier None Typical Low $120.23 Median $134.90 Typical High $141.25 | Professional | None | $120.23 | $134.90 | $141.25 |
AvMed Setting Facility Modifier None Typical Low $199.53 Median $2,137.96 Typical High $11,748.98 | Facility | None | $199.53 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $190.55 Median $245.47 Typical High $323.59 | Professional | None | $190.55 | $245.47 | $323.59 |
Cigna Setting Facility Modifier None Typical Low $54.95 Median $204.17 Typical High $457.09 | Facility | None | $54.95 | $204.17 | $457.09 |
Cigna Setting Professional Modifier None Typical Low $154.88 Median $218.78 Typical High $354.81 | Professional | None | $154.88 | $218.78 | $354.81 |
Florida Blue Setting Facility Modifier None Typical Low $199.53 Median $436.52 Typical High $6,309.57 | Facility | None | $199.53 | $436.52 | $6,309.57 |
Florida Blue Setting Professional Modifier None Typical Low $204.17 Median $223.87 Typical High $331.13 | Professional | None | $204.17 | $223.87 | $331.13 |
Molina Setting Professional Modifier None Typical Low $31.62 Median $213.80 Typical High $346.74 | Professional | None | $31.62 | $213.80 | $346.74 |
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 $138.04 Median $213.80 Typical High $380.19 | Professional | None | $138.04 | $213.80 | $380.19 |
Wellpoint Setting Professional Modifier None Typical Low $144.54 Median $229.09 Typical High $229.09 | Professional | None | $144.54 | $229.09 | $229.09 |
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 $85.11 Median $114.82 Typical High $128.82 | Professional | 52 · Reduced service | $85.11 | $114.82 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $45.71 Typical High $51.29 | Professional | 53 · Discontinued | $33.88 | $45.71 | $51.29 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $173.78 Typical High $194.98 | Professional | 54 · Surgery only | $128.82 | $173.78 | $194.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $34.67 Typical High $38.90 | Professional | 55 · Aftercare only | $25.70 | $34.67 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $22.91 Typical High $25.70 | Professional | 56 · Pre-op care only | $16.98 | $22.91 | $25.70 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $120.23 Median $162.18 Typical High $181.97 | Professional | 78 · Unplanned return to OR | $120.23 | $162.18 | $181.97 |
Where Florida sits
The same service costs 3.9 times more in Alaska than in Texas. 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· 48th of 51
$240
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.