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 $104.71 Median $147.91 Typical High $213.80 | Professional | None | $104.71 | $147.91 | $213.80 |
Ambetter Setting Professional Modifier None Typical Low $144.54 Median $144.54 Typical High $177.83 | Professional | None | $144.54 | $144.54 | $177.83 |
AvMed Setting Facility Modifier None Typical Low $154.88 Median $2,137.96 Typical High $11,748.98 | Facility | None | $154.88 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $107.15 Median $154.88 Typical High $204.17 | Professional | None | $107.15 | $154.88 | $204.17 |
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 $89.13 Median $134.90 Typical High $218.78 | Professional | None | $89.13 | $134.90 | $218.78 |
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 $128.82 Median $141.25 Typical High $208.93 | Professional | None | $128.82 | $141.25 | $208.93 |
Molina Setting Professional Modifier None Typical Low $102.33 Median $162.18 Typical High $245.47 | Professional | None | $102.33 | $162.18 | $245.47 |
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 $79.43 Median $134.90 Typical High $239.88 | Professional | None | $79.43 | $134.90 | $239.88 |
Wellpoint Setting Professional Modifier None Typical Low $85.11 Median $147.91 Typical High $147.91 | Professional | None | $85.11 | $147.91 | $147.91 |
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 $52.48 Median $74.13 Typical High $81.28 | Professional | 52 · Reduced service | $52.48 | $74.13 | $81.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.89 Median $29.51 Typical High $32.36 | Professional | 53 · Discontinued | $20.89 | $29.51 | $32.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $77.62 Median $109.65 Typical High $123.03 | Professional | 54 · Surgery only | $77.62 | $109.65 | $123.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $21.88 Typical High $24.55 | Professional | 55 · Aftercare only | $15.85 | $21.88 | $24.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $14.79 Typical High $16.22 | Professional | 56 · Pre-op care only | $10.47 | $14.79 | $16.22 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $72.44 Median $102.33 Typical High $114.82 | Professional | 78 · Unplanned return to OR | $72.44 | $102.33 | $114.82 |
Where Florida sits
The same service costs 3.3 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· 50th of 51
$148
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.