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 $478.63 Median $3,090.30 Typical High $10,964.78 | Facility | None | $478.63 | $3,090.30 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $194.98 Median $257.04 Typical High $389.05 | Professional | None | $194.98 | $257.04 | $389.05 |
Ambetter Setting Professional Modifier None Typical Low $177.83 Median $263.03 Typical High $263.03 | Professional | None | $177.83 | $263.03 | $263.03 |
AvMed Setting Facility Modifier None Typical Low $354.81 Median $1,479.11 Typical High $9,549.93 | Facility | None | $354.81 | $1,479.11 | $9,549.93 |
AvMed Setting Professional Modifier None Typical Low $218.78 Median $281.84 Typical High $371.54 | Professional | None | $218.78 | $281.84 | $371.54 |
Cigna Setting Facility Modifier None Typical Low $436.52 Median $870.96 Typical High $2,187.76 | Facility | None | $436.52 | $870.96 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $177.83 Median $251.19 Typical High $398.11 | Professional | None | $177.83 | $251.19 | $398.11 |
Florida Blue Setting Facility Modifier None Typical Low $616.60 Median $1,348.96 Typical High $6,309.57 | Facility | None | $616.60 | $1,348.96 | $6,309.57 |
Florida Blue Setting Professional Modifier None Typical Low $234.42 Median $263.03 Typical High $380.19 | Professional | None | $234.42 | $263.03 | $380.19 |
Molina Setting Professional Modifier None Typical Low $34.67 Median $269.15 Typical High $416.87 | Professional | None | $34.67 | $269.15 | $416.87 |
United Setting Facility Modifier None Typical Low $398.11 Median $1,000.00 Typical High $5,623.41 | Facility | None | $398.11 | $1,000.00 | $5,623.41 |
United Setting Professional Modifier None Typical Low $158.49 Median $245.47 Typical High $436.52 | Professional | None | $158.49 | $245.47 | $436.52 |
Wellpoint Setting Professional Modifier None Typical Low $165.96 Median $263.03 Typical High $263.03 | Professional | None | $165.96 | $263.03 | $263.03 |
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 $97.72 Median $128.82 Typical High $147.91 | Professional | 52 · Reduced service | $97.72 | $128.82 | $147.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $51.29 Typical High $58.88 | Professional | 53 · Discontinued | $38.90 | $51.29 | $58.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $144.54 Median $194.98 Typical High $218.78 | Professional | 54 · Surgery only | $144.54 | $194.98 | $218.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $38.90 Typical High $43.65 | Professional | 55 · Aftercare only | $28.84 | $38.90 | $43.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $25.70 Typical High $29.51 | Professional | 56 · Pre-op care only | $19.50 | $25.70 | $29.51 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $134.90 Median $181.97 Typical High $204.17 | Professional | 78 · Unplanned return to OR | $134.90 | $181.97 | $204.17 |
Where Florida sits
The same service costs 4.0 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· 42nd of 51
$316
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.