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 $114.82 Median $128.82 Typical High $181.97 | Professional | None | $114.82 | $128.82 | $181.97 |
Ambetter Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $151.36 | Professional | None | $151.36 | $151.36 | $151.36 |
AvMed Setting Facility Modifier None Typical Low $154.88 Median $2,137.96 Typical High $11,748.98 | Facility | None | $154.88 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $144.54 Median $162.18 Typical High $204.17 | Professional | None | $144.54 | $162.18 | $204.17 |
Cigna Setting Facility Modifier None Typical Low $52.48 Median $147.91 Typical High $288.40 | Facility | None | $52.48 | $147.91 | $288.40 |
Cigna Setting Professional Modifier None Typical Low $104.71 Median $131.83 Typical High $239.88 | Professional | None | $104.71 | $131.83 | $239.88 |
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 $66.07 Median $147.91 Typical High $208.93 | Professional | None | $66.07 | $147.91 | $208.93 |
Molina Setting Professional Modifier None Typical Low $27.54 Median $131.83 Typical High $239.88 | Professional | None | $27.54 | $131.83 | $239.88 |
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 $100.00 Median $134.90 Typical High $269.15 | Professional | None | $100.00 | $134.90 | $269.15 |
Wellpoint Setting Professional Modifier None Typical Low $120.23 Median $151.36 Typical High $151.36 | Professional | None | $120.23 | $151.36 | $151.36 |
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 $57.54 Median $64.57 Typical High $89.13 | Professional | 52 · Reduced service | $57.54 | $64.57 | $89.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $25.70 Typical High $35.48 | Professional | 53 · Discontinued | $22.91 | $25.70 | $35.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $85.11 Median $97.72 Typical High $131.83 | Professional | 54 · Surgery only | $85.11 | $97.72 | $131.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $19.50 Typical High $26.30 | Professional | 55 · Aftercare only | $16.98 | $19.50 | $26.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $12.88 Typical High $17.78 | Professional | 56 · Pre-op care only | $11.48 | $12.88 | $17.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $79.43 Median $91.20 Typical High $123.03 | Professional | 78 · Unplanned return to OR | $79.43 | $91.20 | $123.03 |
Where Florida sits
The same service costs 4.6 times more in Alaska than in Florida. 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· 51st of 51
$135
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.