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 $478.63 Median $3,801.89 Typical High $10,964.78 | Facility | None | $478.63 | $3,801.89 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $234.42 Median $316.23 Typical High $426.58 | Professional | None | $234.42 | $316.23 | $426.58 |
Ambetter Setting Professional Modifier None Typical Low $371.54 Median $371.54 Typical High $371.54 | Professional | None | $371.54 | $371.54 | $371.54 |
AvMed Setting Facility Modifier None Typical Low $295.12 Median $2,137.96 Typical High $11,748.98 | Facility | None | $295.12 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $281.84 Median $354.81 Typical High $467.74 | Professional | None | $281.84 | $354.81 | $467.74 |
Cigna Setting Facility Modifier None Typical Low $269.15 Median $457.09 Typical High $2,691.53 | Facility | None | $269.15 | $457.09 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $199.53 Median $302.00 Typical High $537.03 | Professional | None | $199.53 | $302.00 | $537.03 |
Florida Blue Setting Facility Modifier None Typical Low $281.84 Median $602.56 Typical High $6,309.57 | Facility | None | $281.84 | $602.56 | $6,309.57 |
Florida Blue Setting Professional Modifier None Typical Low $162.18 Median $354.81 Typical High $457.09 | Professional | None | $162.18 | $354.81 | $457.09 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $229.09 Typical High $446.68 | Professional | None | $30.20 | $229.09 | $446.68 |
United Setting Facility Modifier None Typical Low $794.33 Median $1,778.28 Typical High $7,585.78 | Facility | None | $794.33 | $1,778.28 | $7,585.78 |
United Setting Professional Modifier None Typical Low $199.53 Median $309.03 Typical High $602.56 | Professional | None | $199.53 | $309.03 | $602.56 |
Wellpoint Setting Professional Modifier None Typical Low $208.93 Median $331.13 Typical High $331.13 | Professional | None | $208.93 | $331.13 | $331.13 |
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 $117.49 Median $158.49 Typical High $208.93 | Professional | 52 · Reduced service | $117.49 | $158.49 | $208.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $46.77 Median $63.10 Typical High $83.18 | Professional | 53 · Discontinued | $46.77 | $63.10 | $83.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $173.78 Median $239.88 Typical High $316.23 | Professional | 54 · Surgery only | $173.78 | $239.88 | $316.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $47.86 Typical High $63.10 | Professional | 55 · Aftercare only | $34.67 | $47.86 | $63.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.44 Median $31.62 Typical High $41.69 | Professional | 56 · Pre-op care only | $23.44 | $31.62 | $41.69 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $162.18 Median $223.87 Typical High $295.12 | Professional | 78 · Unplanned return to OR | $162.18 | $223.87 | $295.12 |
Where Florida sits
The same service costs 4.7 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· 48th of 51
$316
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.