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 $218.78 Median $281.84 Typical High $416.87 | Professional | None | $218.78 | $281.84 | $416.87 |
Ambetter Setting Professional Modifier None Typical Low $316.23 Median $549.54 Typical High $676.08 | Professional | None | $316.23 | $549.54 | $676.08 |
AvMed Setting Facility Modifier None Typical Low $131.83 Median $954.99 Typical High $9,549.93 | Facility | None | $131.83 | $954.99 | $9,549.93 |
AvMed Setting Professional Modifier None Typical Low $275.42 Median $323.59 Typical High $389.05 | Professional | None | $275.42 | $323.59 | $389.05 |
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 $218.78 Median $251.19 Typical High $467.74 | Professional | None | $218.78 | $251.19 | $467.74 |
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 $123.03 Median $281.84 Typical High $398.11 | Professional | None | $123.03 | $281.84 | $398.11 |
Molina Setting Professional Modifier None Typical Low $31.62 Median $213.80 Typical High $446.68 | Professional | None | $31.62 | $213.80 | $446.68 |
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 $199.53 Median $263.03 Typical High $512.86 | Professional | None | $199.53 | $263.03 | $512.86 |
Wellpoint Setting Professional Modifier None Typical Low $239.88 Median $288.40 Typical High $288.40 | Professional | None | $239.88 | $288.40 | $288.40 |
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 $109.65 Median $128.82 Typical High $169.82 | Professional | 52 · Reduced service | $109.65 | $128.82 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $43.65 Median $51.29 Typical High $67.61 | Professional | 53 · Discontinued | $43.65 | $51.29 | $67.61 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $165.96 Median $190.55 Typical High $257.04 | Professional | 54 · Surgery only | $165.96 | $190.55 | $257.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.11 Median $38.90 Typical High $51.29 | Professional | 55 · Aftercare only | $33.11 | $38.90 | $51.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $25.70 Typical High $33.88 | Professional | 56 · Pre-op care only | $21.88 | $25.70 | $33.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $154.88 Median $177.83 Typical High $239.88 | Professional | 78 · Unplanned return to OR | $154.88 | $177.83 | $239.88 |
Where Florida sits
The same service costs 5.8 times more in Alaska than in Utah. 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
$257
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.