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 $190.55 Median $229.09 Typical High $316.23 | Professional | None | $190.55 | $229.09 | $316.23 |
Ambetter Setting Professional Modifier None Typical Low $323.59 Median $323.59 Typical High $323.59 | Professional | None | $323.59 | $323.59 | $323.59 |
AvMed Setting Facility Modifier None Typical Low $257.04 Median $2,137.96 Typical High $11,748.98 | Facility | None | $257.04 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $229.09 Median $275.42 Typical High $323.59 | Professional | None | $229.09 | $275.42 | $323.59 |
Cigna Setting Facility Modifier None Typical Low $131.83 Median $281.84 Typical High $1,659.59 | Facility | None | $131.83 | $281.84 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $190.55 Median $208.93 Typical High $389.05 | Professional | None | $190.55 | $208.93 | $389.05 |
Florida Blue Setting Facility Modifier None Typical Low $64.57 Median $131.83 Typical High $3,019.95 | Facility | None | $64.57 | $131.83 | $3,019.95 |
Florida Blue Setting Professional Modifier None Typical Low $102.33 Median $239.88 Typical High $331.13 | Professional | None | $102.33 | $239.88 | $331.13 |
Molina Setting Professional Modifier None Typical Low $31.62 Median $181.97 Typical High $354.81 | Professional | None | $31.62 | $181.97 | $354.81 |
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 $169.82 Median $223.87 Typical High $436.52 | Professional | None | $169.82 | $223.87 | $436.52 |
Wellpoint Setting Professional Modifier None Typical Low $208.93 Median $239.88 Typical High $239.88 | Professional | None | $208.93 | $239.88 | $239.88 |
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 $95.50 Median $112.20 Typical High $144.54 | Professional | 52 · Reduced service | $95.50 | $112.20 | $144.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $44.67 Typical High $57.54 | Professional | 53 · Discontinued | $38.02 | $44.67 | $57.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $141.25 Median $165.96 Typical High $213.80 | Professional | 54 · Surgery only | $141.25 | $165.96 | $213.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $33.11 Typical High $42.66 | Professional | 55 · Aftercare only | $28.18 | $33.11 | $42.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $22.39 Typical High $28.84 | Professional | 56 · Pre-op care only | $19.05 | $22.39 | $28.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $131.83 Median $154.88 Typical High $199.53 | Professional | 78 · Unplanned return to OR | $131.83 | $154.88 | $199.53 |
Where Florida sits
The same service costs 5.9 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
$214
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.