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 $234.42 Median $302.00 Typical High $446.68 | Professional | None | $234.42 | $302.00 | $446.68 |
Ambetter Setting Professional Modifier None Typical Low $177.83 Median $331.13 Typical High $354.81 | Professional | None | $177.83 | $331.13 | $354.81 |
AvMed Setting Facility Modifier None Typical Low $407.38 Median $1,479.11 Typical High $9,549.93 | Facility | None | $407.38 | $1,479.11 | $9,549.93 |
AvMed Setting Professional Modifier None Typical Low $257.04 Median $331.13 Typical High $436.52 | Professional | None | $257.04 | $331.13 | $436.52 |
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 $208.93 Median $288.40 Typical High $467.74 | Professional | None | $208.93 | $288.40 | $467.74 |
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 $275.42 Median $309.03 Typical High $446.68 | Professional | None | $275.42 | $309.03 | $446.68 |
Molina Setting Professional Modifier None Typical Low $34.67 Median $323.59 Typical High $501.19 | Professional | None | $34.67 | $323.59 | $501.19 |
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 $186.21 Median $288.40 Typical High $512.86 | Professional | None | $186.21 | $288.40 | $512.86 |
Wellpoint Setting Professional Modifier None Typical Low $194.98 Median $302.00 Typical High $302.00 | Professional | None | $194.98 | $302.00 | $302.00 |
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 $117.49 Median $151.36 Typical High $169.82 | Professional | 52 · Reduced service | $117.49 | $151.36 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $46.77 Median $61.66 Typical High $67.61 | Professional | 53 · Discontinued | $46.77 | $61.66 | $67.61 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $173.78 Median $229.09 Typical High $257.04 | Professional | 54 · Surgery only | $173.78 | $229.09 | $257.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $45.71 Typical High $51.29 | Professional | 55 · Aftercare only | $34.67 | $45.71 | $51.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.44 Median $30.20 Typical High $33.88 | Professional | 56 · Pre-op care only | $23.44 | $30.20 | $33.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $162.18 Median $213.80 Typical High $239.88 | Professional | 78 · Unplanned return to OR | $162.18 | $213.80 | $239.88 |
Where Florida sits
The same service costs 3.9 times more in Alaska than in Utah. 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· 40th of 51
$372
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.