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 $457.09 Median $3,019.95 Typical High $10,964.78 | Facility | None | $457.09 | $3,019.95 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $114.82 Median $147.91 Typical High $234.42 | Professional | None | $114.82 | $147.91 | $234.42 |
Ambetter Setting Professional Modifier None Typical Low $181.97 Median $251.19 Typical High $251.19 | Professional | None | $181.97 | $251.19 | $251.19 |
AvMed Setting Facility Modifier None Typical Low $158.49 Median $2,137.96 Typical High $11,748.98 | Facility | None | $158.49 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $144.54 Median $181.97 Typical High $239.88 | Professional | None | $144.54 | $181.97 | $239.88 |
Cigna Setting Facility Modifier None Typical Low $158.49 Median $302.00 Typical High $1,659.59 | Facility | None | $158.49 | $302.00 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $104.71 Median $151.36 Typical High $263.03 | Professional | None | $104.71 | $151.36 | $263.03 |
Florida Blue Setting Facility Modifier None Typical Low $114.82 Median $251.19 Typical High $6,309.57 | Facility | None | $114.82 | $251.19 | $6,309.57 |
Florida Blue Setting Professional Modifier None Typical Low $75.86 Median $177.83 Typical High $245.47 | Professional | None | $75.86 | $177.83 | $245.47 |
Molina Setting Professional Modifier None Typical Low $128.82 Median $181.97 Typical High $316.23 | Professional | None | $128.82 | $181.97 | $316.23 |
United Setting Facility Modifier None Typical Low $281.84 Median $660.69 Typical High $4,073.80 | Facility | None | $281.84 | $660.69 | $4,073.80 |
United Setting Professional Modifier None Typical Low $102.33 Median $151.36 Typical High $302.00 | Professional | None | $102.33 | $151.36 | $302.00 |
Wellpoint Setting Professional Modifier None Typical Low $109.65 Median $177.83 Typical High $177.83 | Professional | None | $109.65 | $177.83 | $177.83 |
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 $57.54 Median $74.13 Typical High $102.33 | Professional | 52 · Reduced service | $57.54 | $74.13 | $102.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $29.51 Typical High $40.74 | Professional | 53 · Discontinued | $22.91 | $29.51 | $40.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $85.11 Median $112.20 Typical High $151.36 | Professional | 54 · Surgery only | $85.11 | $112.20 | $151.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $22.39 Typical High $30.20 | Professional | 55 · Aftercare only | $16.98 | $22.39 | $30.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $14.79 Typical High $20.42 | Professional | 56 · Pre-op care only | $11.48 | $14.79 | $20.42 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $79.43 Median $104.71 Typical High $141.25 | Professional | 78 · Unplanned return to OR | $79.43 | $104.71 | $141.25 |
Where Florida sits
The same service costs 3.5 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
$174
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.