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 $208.93 Median $251.19 Typical High $371.54 | Professional | None | $208.93 | $251.19 | $371.54 |
Ambetter Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $331.13 | Professional | None | $331.13 | $331.13 | $331.13 |
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 $263.03 Median $309.03 Typical High $363.08 | Professional | None | $263.03 | $309.03 | $363.08 |
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 $208.93 Median $234.42 Typical High $436.52 | Professional | None | $208.93 | $234.42 | $436.52 |
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 $117.49 Median $269.15 Typical High $371.54 | Professional | None | $117.49 | $269.15 | $371.54 |
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 $186.21 Median $251.19 Typical High $489.78 | Professional | None | $186.21 | $251.19 | $489.78 |
Wellpoint Setting Professional Modifier None Typical Low $223.87 Median $269.15 Typical High $269.15 | Professional | None | $223.87 | $269.15 | $269.15 |
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 $104.71 Median $123.03 Typical High $162.18 | Professional | 52 · Reduced service | $104.71 | $123.03 | $162.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $48.98 Typical High $64.57 | Professional | 53 · Discontinued | $41.69 | $48.98 | $64.57 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $158.49 Median $181.97 Typical High $239.88 | Professional | 54 · Surgery only | $158.49 | $181.97 | $239.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $36.31 Typical High $48.98 | Professional | 55 · Aftercare only | $31.62 | $36.31 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $24.55 Typical High $32.36 | Professional | 56 · Pre-op care only | $20.89 | $24.55 | $32.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $147.91 Median $169.82 Typical High $223.87 | Professional | 78 · Unplanned return to OR | $147.91 | $169.82 | $223.87 |
Where Florida sits
The same service costs 5.8 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
$240
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.