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 $229.09 Median $269.15 Typical High $389.05 | Professional | None | $229.09 | $269.15 | $389.05 |
Ambetter Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $478.63 | Professional | None | $389.05 | $389.05 | $478.63 |
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 $288.40 Median $331.13 Typical High $398.11 | Professional | None | $288.40 | $331.13 | $398.11 |
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 $478.63 | Professional | None | $218.78 | $251.19 | $478.63 |
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 $125.89 Median $295.12 Typical High $407.38 | Professional | None | $125.89 | $295.12 | $407.38 |
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 $208.93 Median $269.15 Typical High $537.03 | Professional | None | $208.93 | $269.15 | $537.03 |
Wellpoint Setting Professional Modifier None Typical Low $251.19 Median $295.12 Typical High $295.12 | Professional | None | $251.19 | $295.12 | $295.12 |
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 $114.82 Median $131.83 Typical High $173.78 | Professional | 52 · Reduced service | $114.82 | $131.83 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $52.48 Typical High $70.79 | Professional | 53 · Discontinued | $45.71 | $52.48 | $70.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $169.82 Median $199.53 Typical High $263.03 | Professional | 54 · Surgery only | $169.82 | $199.53 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $39.81 Typical High $52.48 | Professional | 55 · Aftercare only | $33.88 | $39.81 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $26.30 Typical High $35.48 | Professional | 56 · Pre-op care only | $22.91 | $26.30 | $35.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $158.49 Median $186.21 Typical High $245.47 | Professional | 78 · Unplanned return to OR | $158.49 | $186.21 | $245.47 |
Where Florida sits
The same service costs 5.9 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.