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 $630.96 Median $4,786.30 Typical High $11,748.98 | Facility | None | $630.96 | $4,786.30 | $11,748.98 |
Aetna Setting Professional Modifier None Typical Low $512.86 Median $524.81 Typical High $691.83 | Professional | None | $512.86 | $524.81 | $691.83 |
Ambetter Setting Professional Modifier None Typical Low $891.25 Median $891.25 Typical High $891.25 | Professional | None | $891.25 | $891.25 | $891.25 |
AvMed Setting Facility Modifier None Typical Low $512.86 Median $2,089.30 Typical High $9,772.37 | Facility | None | $512.86 | $2,089.30 | $9,772.37 |
AvMed Setting Professional Modifier None Typical Low $467.74 Median $630.96 Typical High $724.44 | Professional | None | $467.74 | $630.96 | $724.44 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $1,905.46 Typical High $2,951.21 | Facility | None | $501.19 | $1,905.46 | $2,951.21 |
Cigna Setting Professional Modifier None Typical Low $436.52 Median $457.09 Typical High $954.99 | Professional | None | $436.52 | $457.09 | $954.99 |
Florida Blue Setting Facility Modifier None Typical Low $1,230.27 Median $2,630.27 Typical High $16,982.44 | Facility | None | $1,230.27 | $2,630.27 | $16,982.44 |
Florida Blue Setting Professional Modifier None Typical Low $257.04 Median $562.34 Typical High $812.83 | Professional | None | $257.04 | $562.34 | $812.83 |
Molina Setting Professional Modifier None Typical Low $60.26 Median $371.54 Typical High $724.44 | Professional | None | $60.26 | $371.54 | $724.44 |
United Setting Facility Modifier None Typical Low $954.99 Median $2,344.23 Typical High $10,000.00 | Facility | None | $954.99 | $2,344.23 | $10,000.00 |
United Setting Professional Modifier None Typical Low $398.11 Median $537.03 Typical High $1,023.29 | Professional | None | $398.11 | $537.03 | $1,023.29 |
Wellpoint Setting Professional Modifier None Typical Low $446.68 Median $446.68 Typical High $588.84 | Professional | None | $446.68 | $446.68 | $588.84 |
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 $257.04 Median $263.03 Typical High $331.13 | Professional | 52 · Reduced service | $257.04 | $263.03 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $104.71 Typical High $131.83 | Professional | 53 · Discontinued | $102.33 | $104.71 | $131.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $389.05 Typical High $489.78 | Professional | 54 · Surgery only | $380.19 | $389.05 | $489.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $79.43 Typical High $100.00 | Professional | 55 · Aftercare only | $75.86 | $79.43 | $100.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $52.48 Typical High $66.07 | Professional | 56 · Pre-op care only | $51.29 | $52.48 | $66.07 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $354.81 Median $363.08 Typical High $457.09 | Professional | 78 · Unplanned return to OR | $354.81 | $363.08 | $457.09 |
Where Florida sits
The same service costs 7.4 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
$513
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.