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 $302.00 Median $2,884.03 Typical High $10,964.78 | Facility | None | $302.00 | $2,884.03 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $204.17 Median $269.15 Typical High $398.11 | Professional | None | $204.17 | $269.15 | $398.11 |
Ambetter Setting Professional Modifier None Typical Low $186.21 Median $371.54 Typical High $371.54 | Professional | None | $186.21 | $371.54 | $371.54 |
AvMed Setting Facility Modifier None Typical Low $281.84 Median $2,137.96 Typical High $11,748.98 | Facility | None | $281.84 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $263.03 Median $331.13 Typical High $416.87 | Professional | None | $263.03 | $331.13 | $416.87 |
Cigna Setting Facility Modifier None Typical Low $56.23 Median $316.23 Typical High $602.56 | Facility | None | $56.23 | $316.23 | $602.56 |
Cigna Setting Professional Modifier None Typical Low $186.21 Median $263.03 Typical High $457.09 | Professional | None | $186.21 | $263.03 | $457.09 |
Florida Blue Setting Facility Modifier None Typical Low $199.53 Median $436.52 Typical High $6,309.57 | Facility | None | $199.53 | $436.52 | $6,309.57 |
Florida Blue Setting Professional Modifier None Typical Low $128.82 Median $309.03 Typical High $426.58 | Professional | None | $128.82 | $309.03 | $426.58 |
Molina Setting Professional Modifier None Typical Low $31.62 Median $234.42 Typical High $467.74 | Professional | None | $31.62 | $234.42 | $467.74 |
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 $186.21 Median $263.03 Typical High $524.81 | Professional | None | $186.21 | $263.03 | $524.81 |
Wellpoint Setting Professional Modifier None Typical Low $194.98 Median $309.03 Typical High $309.03 | Professional | None | $194.98 | $309.03 | $309.03 |
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 $100.00 Median $128.82 Typical High $173.78 | Professional | 52 · Reduced service | $100.00 | $128.82 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $51.29 Typical High $69.18 | Professional | 53 · Discontinued | $40.74 | $51.29 | $69.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $151.36 Median $190.55 Typical High $263.03 | Professional | 54 · Surgery only | $151.36 | $190.55 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $38.02 Typical High $52.48 | Professional | 55 · Aftercare only | $30.20 | $38.02 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $25.70 Typical High $34.67 | Professional | 56 · Pre-op care only | $20.42 | $25.70 | $34.67 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $141.25 Median $177.83 Typical High $245.47 | Professional | 78 · Unplanned return to OR | $141.25 | $177.83 | $245.47 |
Where Florida sits
The same service costs 4.5 times more in Alaska than in Texas. 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
$275
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.