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 $208.93 Median $2,951.21 Typical High $10,964.78 | Facility | None | $208.93 | $2,951.21 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $107.15 Median $173.78 Typical High $269.15 | Professional | None | $107.15 | $173.78 | $269.15 |
Ambetter Setting Professional Modifier None Typical Low $223.87 Median $223.87 Typical High $275.42 | Professional | None | $223.87 | $223.87 | $275.42 |
AvMed Setting Facility Modifier None Typical Low $165.96 Median $2,137.96 Typical High $11,748.98 | Facility | None | $165.96 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $131.83 Median $199.53 Typical High $257.04 | Professional | None | $131.83 | $199.53 | $257.04 |
Cigna Setting Facility Modifier None Typical Low $165.96 Median $302.00 Typical High $1,659.59 | Facility | None | $165.96 | $302.00 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $93.33 Median $165.96 Typical High $295.12 | Professional | None | $93.33 | $165.96 | $295.12 |
Florida Blue Setting Facility Modifier None Typical Low $199.53 Median $436.52 Typical High $4,466.84 | Facility | None | $199.53 | $436.52 | $4,466.84 |
Florida Blue Setting Professional Modifier None Typical Low $91.20 Median $204.17 Typical High $257.04 | Professional | None | $91.20 | $204.17 | $257.04 |
Molina Setting Professional Modifier None Typical Low $27.54 Median $165.96 Typical High $295.12 | Professional | None | $27.54 | $165.96 | $295.12 |
United Setting Facility Modifier None Typical Low $281.84 Median $660.69 Typical High $4,073.80 | Facility | None | $281.84 | $660.69 | $4,073.80 |
United Setting Professional Modifier None Typical Low $93.33 Median $173.78 Typical High $331.13 | Professional | None | $93.33 | $173.78 | $331.13 |
Wellpoint Setting Professional Modifier None Typical Low $100.00 Median $186.21 Typical High $186.21 | Professional | None | $100.00 | $186.21 | $186.21 |
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 $53.70 Median $91.20 Typical High $114.82 | Professional | 52 · Reduced service | $53.70 | $91.20 | $114.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $36.31 Typical High $45.71 | Professional | 53 · Discontinued | $21.38 | $36.31 | $45.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $81.28 Median $138.04 Typical High $173.78 | Professional | 54 · Surgery only | $81.28 | $138.04 | $173.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $27.54 Typical High $34.67 | Professional | 55 · Aftercare only | $16.22 | $27.54 | $34.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $18.20 Typical High $22.91 | Professional | 56 · Pre-op care only | $10.72 | $18.20 | $22.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $75.86 Median $128.82 Typical High $162.18 | Professional | 78 · Unplanned return to OR | $75.86 | $128.82 | $162.18 |
Where Florida sits
The same service costs 3.6 times more in Alaska than in Kentucky. 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· 47th of 51
$182
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.