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 $81.28 Median $134.90 Typical High $213.80 | Professional | None | $81.28 | $134.90 | $213.80 |
AvMed Setting Facility Modifier None Typical Low $128.82 Median $2,137.96 Typical High $11,748.98 | Facility | None | $128.82 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $102.33 Median $154.88 Typical High $199.53 | Professional | None | $102.33 | $154.88 | $199.53 |
Cigna Setting Facility Modifier None Typical Low $52.48 Median $141.25 Typical High $275.42 | Facility | None | $52.48 | $141.25 | $275.42 |
Cigna Setting Professional Modifier None Typical Low $81.28 Median $138.04 Typical High $295.12 | Professional | None | $81.28 | $138.04 | $295.12 |
Florida Blue Setting Facility Modifier None Typical Low $114.82 Median $251.19 Typical High $3,019.95 | Facility | None | $114.82 | $251.19 | $3,019.95 |
Florida Blue Setting Professional Modifier None Typical Low $117.49 Median $128.82 Typical High $173.78 | Professional | None | $117.49 | $128.82 | $173.78 |
Molina Setting Professional Modifier None Typical Low $109.65 Median $162.18 Typical High $323.59 | Professional | None | $109.65 | $162.18 | $323.59 |
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 $79.43 Median $158.49 Typical High $316.23 | Professional | None | $79.43 | $158.49 | $316.23 |
Wellpoint Setting Professional Modifier None Typical Low $79.43 Median $147.91 Typical High $147.91 | Professional | None | $79.43 | $147.91 | $147.91 |
7 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 $40.74 Median $66.07 Typical High $91.20 | Professional | 52 · Reduced service | $40.74 | $66.07 | $91.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.22 Median $26.92 Typical High $36.31 | Professional | 53 · Discontinued | $16.22 | $26.92 | $36.31 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $61.66 Median $100.00 Typical High $138.04 | Professional | 54 · Surgery only | $61.66 | $100.00 | $138.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $19.95 Typical High $27.54 | Professional | 55 · Aftercare only | $12.30 | $19.95 | $27.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.13 Median $13.49 Typical High $18.20 | Professional | 56 · Pre-op care only | $8.13 | $13.49 | $18.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $57.54 Median $93.33 Typical High $128.82 | Professional | 78 · Unplanned return to OR | $57.54 | $93.33 | $128.82 |
Ambetter Setting Professional Modifier 50 · Both sides Typical Low $141.25 Median $302.00 Typical High $302.00 | Professional | 50 · Both sides | $141.25 | $302.00 | $302.00 |
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· 45th of 51
$158
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.