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 $537.03 Median $3,801.89 Typical High $11,481.54 | Facility | None | $537.03 | $3,801.89 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $338.84 Median $489.78 Typical High $851.14 | Professional | None | $338.84 | $489.78 | $851.14 |
Ambetter Setting Professional Modifier None Typical Low $331.13 Median $389.05 Typical High $457.09 | Professional | None | $331.13 | $389.05 | $457.09 |
AvMed Setting Facility Modifier None Typical Low $302.00 Median $2,137.96 Typical High $11,748.98 | Facility | None | $302.00 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $275.42 Median $426.58 Typical High $537.03 | Professional | None | $275.42 | $426.58 | $537.03 |
Cigna Setting Facility Modifier None Typical Low $218.78 Median $436.52 Typical High $2,691.53 | Facility | None | $218.78 | $436.52 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $208.93 Median $407.38 Typical High $954.99 | Professional | None | $208.93 | $407.38 | $954.99 |
Florida Blue Setting Facility Modifier None Typical Low $363.08 Median $812.83 Typical High $11,748.98 | Facility | None | $363.08 | $812.83 | $11,748.98 |
Florida Blue Setting Professional Modifier None Typical Low $295.12 Median $309.03 Typical High $489.78 | Professional | None | $295.12 | $309.03 | $489.78 |
Molina Setting Professional Modifier None Typical Low $34.67 Median $371.54 Typical High $549.54 | Professional | None | $34.67 | $371.54 | $549.54 |
United Setting Facility Modifier None Typical Low $954.99 Median $2,344.23 Typical High $10,000.00 | Facility | None | $954.99 | $2,344.23 | $10,000.00 |
United Setting Professional Modifier None Typical Low $208.93 Median $478.63 Typical High $1,230.27 | Professional | None | $208.93 | $478.63 | $1,230.27 |
Wellpoint Setting Professional Modifier None Typical Low $190.55 Median $323.59 Typical High $323.59 | Professional | None | $190.55 | $323.59 | $323.59 |
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 $186.21 Median $208.93 Typical High $288.40 | Professional | 52 · Reduced service | $186.21 | $208.93 | $288.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $74.13 Median $83.18 Typical High $114.82 | Professional | 53 · Discontinued | $74.13 | $83.18 | $114.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $275.42 Median $309.03 Typical High $436.52 | Professional | 54 · Surgery only | $275.42 | $309.03 | $436.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $61.66 Typical High $87.10 | Professional | 55 · Aftercare only | $54.95 | $61.66 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $41.69 Typical High $57.54 | Professional | 56 · Pre-op care only | $37.15 | $41.69 | $57.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $257.04 Median $288.40 Typical High $407.38 | Professional | 78 · Unplanned return to OR | $257.04 | $288.40 | $407.38 |
Where Florida sits
The same service costs 4.1 times more in Wisconsin than in Texas. 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
$479
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.