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 $74.13 Median $109.65 Typical High $162.18 | Professional | None | $74.13 | $109.65 | $162.18 |
Ambetter Setting Professional Modifier None Typical Low $54.95 Median $109.65 Typical High $141.25 | Professional | None | $54.95 | $109.65 | $141.25 |
AvMed Setting Facility Modifier None Typical Low $120.23 Median $2,137.96 Typical High $11,748.98 | Facility | None | $120.23 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $77.62 Median $120.23 Typical High $154.88 | Professional | None | $77.62 | $120.23 | $154.88 |
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 $63.10 Median $102.33 Typical High $162.18 | Professional | None | $63.10 | $102.33 | $162.18 |
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 $97.72 Median $107.15 Typical High $158.49 | Professional | None | $97.72 | $107.15 | $158.49 |
Molina Setting Professional Modifier None Typical Low $75.86 Median $112.20 Typical High $169.82 | Professional | None | $75.86 | $112.20 | $169.82 |
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 $60.26 Median $100.00 Typical High $177.83 | Professional | None | $60.26 | $100.00 | $177.83 |
Wellpoint Setting Professional Modifier None Typical Low $61.66 Median $112.20 Typical High $112.20 | Professional | None | $61.66 | $112.20 | $112.20 |
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 $37.15 Median $54.95 Typical High $60.26 | Professional | 52 · Reduced service | $37.15 | $54.95 | $60.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.79 Median $21.88 Typical High $24.55 | Professional | 53 · Discontinued | $14.79 | $21.88 | $24.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $54.95 Median $81.28 Typical High $91.20 | Professional | 54 · Surgery only | $54.95 | $81.28 | $91.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.96 Median $16.22 Typical High $18.20 | Professional | 55 · Aftercare only | $10.96 | $16.22 | $18.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.41 Median $10.96 Typical High $12.30 | Professional | 56 · Pre-op care only | $7.41 | $10.96 | $12.30 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $51.29 Median $75.86 Typical High $85.11 | Professional | 78 · Unplanned return to OR | $51.29 | $75.86 | $85.11 |
Where Florida sits
The same service costs 3.5 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
$112
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.