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 $1,318.26 Median $1,548.82 Typical High $8,709.64 | Facility | None | $1,318.26 | $1,548.82 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $1,258.93 Median $1,445.44 Typical High $1,778.28 | Professional | None | $1,258.93 | $1,445.44 | $1,778.28 |
Ambetter Setting Professional Modifier None Typical Low $2,344.23 Median $2,344.23 Typical High $2,344.23 | Professional | None | $2,344.23 | $2,344.23 | $2,344.23 |
AvMed Setting Facility Modifier None Typical Low $794.33 Median $2,137.96 Typical High $11,748.98 | Facility | None | $794.33 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $1,258.93 Median $1,659.59 Typical High $1,905.46 | Professional | None | $1,258.93 | $1,659.59 | $1,905.46 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $977.24 Typical High $2,691.53 | Facility | None | $501.19 | $977.24 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $933.25 Median $1,230.27 Typical High $2,398.83 | Professional | None | $933.25 | $1,230.27 | $2,398.83 |
Florida Blue Setting Facility Modifier None Typical Low $812.83 Median $1,737.80 Typical High $16,982.44 | Facility | None | $812.83 | $1,737.80 | $16,982.44 |
Florida Blue Setting Professional Modifier None Typical Low $724.44 Median $1,621.81 Typical High $1,995.26 | Professional | None | $724.44 | $1,621.81 | $1,995.26 |
Molina Setting Professional Modifier None Typical Low $131.83 Median $1,071.52 Typical High $1,995.26 | Professional | None | $131.83 | $1,071.52 | $1,995.26 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $3,311.31 Typical High $12,589.25 | Facility | None | $1,230.27 | $3,311.31 | $12,589.25 |
United Setting Professional Modifier None Typical Low $1,000.00 Median $1,380.38 Typical High $2,754.23 | Professional | None | $1,000.00 | $1,380.38 | $2,754.23 |
Wellpoint Setting Professional Modifier None Typical Low $912.01 Median $1,348.96 Typical High $1,348.96 | Professional | None | $912.01 | $1,348.96 | $1,348.96 |
5 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 $630.96 Median $724.44 Typical High $870.96 | Professional | 52 · Reduced service | $630.96 | $724.44 | $870.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $251.19 Median $288.40 Typical High $346.74 | Professional | 53 · Discontinued | $251.19 | $288.40 | $346.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $218.78 Typical High $263.03 | Professional | 55 · Aftercare only | $186.21 | $218.78 | $263.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $125.89 Median $144.54 Typical High $173.78 | Professional | 56 · Pre-op care only | $125.89 | $144.54 | $173.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $1,000.00 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $870.96 | $1,000.00 | $1,230.27 |
Where Florida sits
The same service costs 5.1 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· 49th of 51
$1,349
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.