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 $117.49 Median $162.18 Typical High $234.42 | Professional | None | $117.49 | $162.18 | $234.42 |
Ambetter Setting Professional Modifier None Typical Low $154.88 Median $181.97 Typical High $181.97 | Professional | None | $154.88 | $181.97 | $181.97 |
AvMed Setting Facility Modifier None Typical Low $128.82 Median $2,137.96 Typical High $11,748.98 | Facility | None | $128.82 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $120.23 Median $169.82 Typical High $218.78 | Professional | None | $120.23 | $169.82 | $218.78 |
Cigna Setting Facility Modifier None Typical Low $52.48 Median $141.25 Typical High $275.42 | Facility | None | $52.48 | $141.25 | $275.42 |
Cigna Setting Professional Modifier None Typical Low $100.00 Median $147.91 Typical High $239.88 | Professional | None | $100.00 | $147.91 | $239.88 |
Florida Blue Setting Facility Modifier None Typical Low $114.82 Median $251.19 Typical High $3,981.07 | Facility | None | $114.82 | $251.19 | $3,981.07 |
Florida Blue Setting Professional Modifier None Typical Low $141.25 Median $158.49 Typical High $223.87 | Professional | None | $141.25 | $158.49 | $223.87 |
Molina Setting Professional Modifier None Typical Low $125.89 Median $173.78 Typical High $257.04 | Professional | None | $125.89 | $173.78 | $257.04 |
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 $91.20 Median $147.91 Typical High $263.03 | Professional | None | $91.20 | $147.91 | $263.03 |
Wellpoint Setting Professional Modifier None Typical Low $95.50 Median $158.49 Typical High $158.49 | Professional | None | $95.50 | $158.49 | $158.49 |
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 $58.88 Median $81.28 Typical High $89.13 | Professional | 52 · Reduced service | $58.88 | $81.28 | $89.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $32.36 Typical High $35.48 | Professional | 53 · Discontinued | $23.44 | $32.36 | $35.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $89.13 Median $120.23 Typical High $134.90 | Professional | 54 · Surgery only | $89.13 | $120.23 | $134.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $23.99 Typical High $26.92 | Professional | 55 · Aftercare only | $17.78 | $23.99 | $26.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $16.22 Typical High $17.78 | Professional | 56 · Pre-op care only | $11.75 | $16.22 | $17.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $83.18 Median $112.20 Typical High $125.89 | Professional | 78 · Unplanned return to OR | $83.18 | $112.20 | $125.89 |
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· 49th of 51
$166
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.