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 $213.80 Median $269.15 Typical High $398.11 | Professional | None | $213.80 | $269.15 | $398.11 |
Ambetter Setting Professional Modifier None Typical Low $141.25 Median $331.13 Typical High $363.08 | Professional | None | $141.25 | $331.13 | $363.08 |
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 $269.15 Median $309.03 Typical High $371.54 | Professional | None | $269.15 | $309.03 | $371.54 |
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 $208.93 Median $239.88 Typical High $446.68 | Professional | None | $208.93 | $239.88 | $446.68 |
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 $120.23 Median $275.42 Typical High $380.19 | Professional | None | $120.23 | $275.42 | $380.19 |
Molina Setting Professional Modifier None Typical Low $31.62 Median $213.80 Typical High $416.87 | Professional | None | $31.62 | $213.80 | $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 $194.98 Median $257.04 Typical High $501.19 | Professional | None | $194.98 | $257.04 | $501.19 |
Wellpoint Setting Professional Modifier None Typical Low $229.09 Median $269.15 Typical High $269.15 | Professional | None | $229.09 | $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 $107.15 Median $123.03 Typical High $165.96 | Professional | 52 · Reduced service | $107.15 | $123.03 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $42.66 Median $50.12 Typical High $66.07 | Professional | 53 · Discontinued | $42.66 | $50.12 | $66.07 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $162.18 Median $186.21 Typical High $245.47 | Professional | 54 · Surgery only | $162.18 | $186.21 | $245.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $32.36 Median $37.15 Typical High $48.98 | Professional | 55 · Aftercare only | $32.36 | $37.15 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.38 Median $25.12 Typical High $33.11 | Professional | 56 · Pre-op care only | $21.38 | $25.12 | $33.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $151.36 Median $173.78 Typical High $229.09 | Professional | 78 · Unplanned return to OR | $151.36 | $173.78 | $229.09 |
Where Florida sits
The same service costs 5.5 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
$245
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.