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 $380.19 Median $2,951.21 Typical High $10,964.78 | Facility | None | $380.19 | $2,951.21 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $181.97 Median $239.88 Typical High $363.08 | Professional | None | $181.97 | $239.88 | $363.08 |
Ambetter Setting Professional Modifier None Typical Low $457.09 Median $457.09 Typical High $457.09 | Professional | None | $457.09 | $457.09 | $457.09 |
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 $281.84 Typical High $346.74 | Professional | None | $229.09 | $281.84 | $346.74 |
Cigna Setting Facility Modifier None Typical Low $52.48 Median $147.91 Typical High $295.12 | Facility | None | $52.48 | $147.91 | $295.12 |
Cigna Setting Professional Modifier None Typical Low $186.21 Median $223.87 Typical High $398.11 | Professional | None | $186.21 | $223.87 | $398.11 |
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 $245.47 Typical High $354.81 | Professional | None | $102.33 | $245.47 | $354.81 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $181.97 Typical High $416.87 | Professional | None | $30.20 | $181.97 | $416.87 |
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 $165.96 Median $223.87 Typical High $436.52 | Professional | None | $165.96 | $223.87 | $436.52 |
Wellpoint Setting Professional Modifier None Typical Low $213.80 Median $257.04 Typical High $257.04 | Professional | None | $213.80 | $257.04 | $257.04 |
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 $91.20 Median $109.65 Typical High $144.54 | Professional | 52 · Reduced service | $91.20 | $109.65 | $144.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $43.65 Typical High $57.54 | Professional | 53 · Discontinued | $36.31 | $43.65 | $57.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $162.18 Typical High $218.78 | Professional | 54 · Surgery only | $138.04 | $162.18 | $218.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $33.11 Typical High $43.65 | Professional | 55 · Aftercare only | $27.54 | $33.11 | $43.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $21.88 Typical High $28.84 | Professional | 56 · Pre-op care only | $18.20 | $21.88 | $28.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $128.82 Median $151.36 Typical High $204.17 | Professional | 78 · Unplanned return to OR | $128.82 | $151.36 | $204.17 |
Where Florida sits
The same service costs 5.4 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· 49th of 51
$219
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.