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 $54.95 Median $74.13 Typical High $109.65 | Professional | None | $54.95 | $74.13 | $109.65 |
Ambetter Setting Professional Modifier None Typical Low $74.13 Median $74.13 Typical High $95.50 | Professional | None | $74.13 | $74.13 | $95.50 |
AvMed Setting Facility Modifier None Typical Low $79.43 Median $2,137.96 Typical High $11,748.98 | Facility | None | $79.43 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $61.66 Median $79.43 Typical High $104.71 | Professional | None | $61.66 | $79.43 | $104.71 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $66.07 Typical High $724.44 | Facility | None | $50.12 | $66.07 | $724.44 |
Cigna Setting Professional Modifier None Typical Low $51.29 Median $72.44 Typical High $114.82 | Professional | None | $51.29 | $72.44 | $114.82 |
Florida Blue Setting Facility Modifier None Typical Low $64.57 Median $138.04 Typical High $3,019.95 | Facility | None | $64.57 | $138.04 | $3,019.95 |
Florida Blue Setting Professional Modifier None Typical Low $66.07 Median $74.13 Typical High $107.15 | Professional | None | $66.07 | $74.13 | $107.15 |
Molina Setting Professional Modifier None Typical Low $53.70 Median $85.11 Typical High $134.90 | Professional | None | $53.70 | $85.11 | $134.90 |
United Setting Facility Modifier None Typical Low $81.28 Median $302.00 Typical High $2,818.38 | Facility | None | $81.28 | $302.00 | $2,818.38 |
United Setting Professional Modifier None Typical Low $48.98 Median $69.18 Typical High $125.89 | Professional | None | $48.98 | $69.18 | $125.89 |
Wellpoint Setting Professional Modifier None Typical Low $48.98 Median $75.86 Typical High $75.86 | Professional | None | $48.98 | $75.86 | $75.86 |
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 $27.54 Median $37.15 Typical High $40.74 | Professional | 52 · Reduced service | $27.54 | $37.15 | $40.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.96 Median $14.79 Typical High $16.22 | Professional | 53 · Discontinued | $10.96 | $14.79 | $16.22 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $41.69 Median $56.23 Typical High $60.26 | Professional | 54 · Surgery only | $41.69 | $56.23 | $60.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.32 Median $11.22 Typical High $12.30 | Professional | 55 · Aftercare only | $8.32 | $11.22 | $12.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.50 Median $7.41 Typical High $8.13 | Professional | 56 · Pre-op care only | $5.50 | $7.41 | $8.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $38.90 Median $52.48 Typical High $56.23 | Professional | 78 · Unplanned return to OR | $38.90 | $52.48 | $56.23 |
Where Florida sits
The same service costs 3.8 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· 48th of 51
$81.28
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.