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 $123.03 Median $2,951.21 Typical High $12,022.64 | Facility | None | $123.03 | $2,951.21 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $91.20 Median $147.91 Typical High $251.19 | Professional | None | $91.20 | $147.91 | $251.19 |
Ambetter Setting Professional Modifier None Typical Low $199.53 Median $371.54 Typical High $457.09 | Professional | None | $199.53 | $371.54 | $457.09 |
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 $114.82 Median $173.78 Typical High $229.09 | Professional | None | $114.82 | $173.78 | $229.09 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $66.07 Typical High $724.44 | Facility | None | $50.12 | $66.07 | $724.44 |
Cigna Setting Professional Modifier None Typical Low $91.20 Median $154.88 Typical High $331.13 | Professional | None | $91.20 | $154.88 | $331.13 |
Florida Blue Setting Facility Modifier None Typical Low $34.67 Median $70.79 Typical High $2,137.96 | Facility | None | $34.67 | $70.79 | $2,137.96 |
Florida Blue Setting Professional Modifier None Typical Low $120.23 Median $144.54 Typical High $204.17 | Professional | None | $120.23 | $144.54 | $204.17 |
Molina Setting Professional Modifier None Typical Low $31.62 Median $165.96 Typical High $346.74 | Professional | None | $31.62 | $165.96 | $346.74 |
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 $87.10 Median $169.82 Typical High $338.84 | Professional | None | $87.10 | $169.82 | $338.84 |
Wellpoint Setting Professional Modifier None Typical Low $89.13 Median $165.96 Typical High $165.96 | Professional | None | $89.13 | $165.96 | $165.96 |
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 $45.71 Median $72.44 Typical High $100.00 | Professional | 52 · Reduced service | $45.71 | $72.44 | $100.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.20 Median $28.84 Typical High $39.81 | Professional | 53 · Discontinued | $18.20 | $28.84 | $39.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $67.61 Median $107.15 Typical High $147.91 | Professional | 54 · Surgery only | $67.61 | $107.15 | $147.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.49 Median $21.38 Typical High $29.51 | Professional | 55 · Aftercare only | $13.49 | $21.38 | $29.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $14.45 Typical High $19.95 | Professional | 56 · Pre-op care only | $9.12 | $14.45 | $19.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $63.10 Median $100.00 Typical High $138.04 | Professional | 78 · Unplanned return to OR | $63.10 | $100.00 | $138.04 |
Where Florida sits
The same service costs 4.5 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· 48th of 51
$155
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.