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 $331.13 Median $3,019.95 Typical High $10,964.78 | Facility | None | $331.13 | $3,019.95 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $218.78 Median $288.40 Typical High $436.52 | Professional | None | $218.78 | $288.40 | $436.52 |
Ambetter Setting Professional Modifier None Typical Low $190.55 Median $346.74 Typical High $380.19 | Professional | None | $190.55 | $346.74 | $380.19 |
AvMed Setting Facility Modifier None Typical Low $208.93 Median $954.99 Typical High $9,549.93 | Facility | None | $208.93 | $954.99 | $9,549.93 |
AvMed Setting Professional Modifier None Typical Low $218.78 Median $316.23 Typical High $416.87 | Professional | None | $218.78 | $316.23 | $416.87 |
Cigna Setting Facility Modifier None Typical Low $218.78 Median $398.11 Typical High $2,187.76 | Facility | None | $218.78 | $398.11 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $177.83 Median $281.84 Typical High $446.68 | Professional | None | $177.83 | $281.84 | $446.68 |
Florida Blue Setting Facility Modifier None Typical Low $125.89 Median $316.23 Typical High $5,011.87 | Facility | None | $125.89 | $316.23 | $5,011.87 |
Florida Blue Setting Professional Modifier None Typical Low $269.15 Median $288.40 Typical High $426.58 | Professional | None | $269.15 | $288.40 | $426.58 |
Molina Setting Professional Modifier None Typical Low $34.67 Median $302.00 Typical High $457.09 | Professional | None | $34.67 | $302.00 | $457.09 |
United Setting Facility Modifier None Typical Low $81.28 Median $302.00 Typical High $2,754.23 | Facility | None | $81.28 | $302.00 | $2,754.23 |
United Setting Professional Modifier None Typical Low $162.18 Median $275.42 Typical High $478.63 | Professional | None | $162.18 | $275.42 | $478.63 |
Wellpoint Setting Professional Modifier None Typical Low $165.96 Median $302.00 Typical High $302.00 | Professional | None | $165.96 | $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 $104.71 Median $141.25 Typical High $165.96 | Professional | 52 · Reduced service | $104.71 | $141.25 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $56.23 Typical High $66.07 | Professional | 53 · Discontinued | $41.69 | $56.23 | $66.07 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $158.49 Median $208.93 Typical High $245.47 | Professional | 54 · Surgery only | $158.49 | $208.93 | $245.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $41.69 Typical High $50.12 | Professional | 55 · Aftercare only | $31.62 | $41.69 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $28.18 Typical High $33.11 | Professional | 56 · Pre-op care only | $20.89 | $28.18 | $33.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $147.91 Median $194.98 Typical High $229.09 | Professional | 78 · Unplanned return to OR | $147.91 | $194.98 | $229.09 |
Where Florida sits
The same service costs 3.5 times more in Alaska than in Maryland. 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
$295
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.