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 $72.44 Median $85.11 Typical High $114.82 | Professional | None | $72.44 | $85.11 | $114.82 |
Ambetter Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $120.23 | Professional | None | $120.23 | $120.23 | $120.23 |
AvMed Setting Facility Modifier None Typical Low $93.33 Median $2,137.96 Typical High $11,748.98 | Facility | None | $93.33 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $87.10 Median $107.15 Typical High $134.90 | Professional | None | $87.10 | $107.15 | $134.90 |
Cigna Setting Facility Modifier None Typical Low $52.48 Median $91.20 Typical High $177.83 | Facility | None | $52.48 | $91.20 | $177.83 |
Cigna Setting Professional Modifier None Typical Low $63.10 Median $87.10 Typical High $151.36 | Professional | None | $63.10 | $87.10 | $151.36 |
Florida Blue Setting Facility Modifier None Typical Low $60.26 Median $131.83 Typical High $6,309.57 | Facility | None | $60.26 | $131.83 | $6,309.57 |
Florida Blue Setting Professional Modifier None Typical Low $43.65 Median $102.33 Typical High $204.17 | Professional | None | $43.65 | $102.33 | $204.17 |
Molina Setting Professional Modifier None Typical Low $70.79 Median $91.20 Typical High $151.36 | Professional | None | $70.79 | $91.20 | $151.36 |
United Setting Facility Modifier None Typical Low $398.11 Median $1,000.00 Typical High $5,623.41 | Facility | None | $398.11 | $1,000.00 | $5,623.41 |
United Setting Professional Modifier None Typical Low $61.66 Median $85.11 Typical High $169.82 | Professional | None | $61.66 | $85.11 | $169.82 |
Wellpoint Setting Professional Modifier None Typical Low $64.57 Median $100.00 Typical High $100.00 | Professional | None | $64.57 | $100.00 | $100.00 |
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 $36.31 Median $43.65 Typical High $57.54 | Professional | 52 · Reduced service | $36.31 | $43.65 | $57.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.45 Median $17.38 Typical High $22.91 | Professional | 53 · Discontinued | $14.45 | $17.38 | $22.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $53.70 Median $66.07 Typical High $85.11 | Professional | 54 · Surgery only | $53.70 | $66.07 | $85.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.72 Median $13.18 Typical High $16.98 | Professional | 55 · Aftercare only | $10.72 | $13.18 | $16.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.24 Median $8.71 Typical High $11.48 | Professional | 56 · Pre-op care only | $7.24 | $8.71 | $11.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $50.12 Median $61.66 Typical High $79.43 | Professional | 78 · Unplanned return to OR | $50.12 | $61.66 | $79.43 |
Where Florida sits
The same service costs 4.0 times more in Alaska than in Florida. 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· 51st of 51
$91.20
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.