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 $575.44 Median $3,890.45 Typical High $11,481.54 | Facility | None | $575.44 | $3,890.45 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $407.38 Median $575.44 Typical High $1,047.13 | Professional | None | $407.38 | $575.44 | $1,047.13 |
Ambetter Setting Professional Modifier None Typical Low $398.11 Median $467.74 Typical High $537.03 | Professional | None | $398.11 | $467.74 | $537.03 |
AvMed Setting Facility Modifier None Typical Low $371.54 Median $2,137.96 Typical High $11,748.98 | Facility | None | $371.54 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $338.84 Median $512.86 Typical High $660.69 | Professional | None | $338.84 | $512.86 | $660.69 |
Cigna Setting Facility Modifier None Typical Low $251.19 Median $457.09 Typical High $2,691.53 | Facility | None | $251.19 | $457.09 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $257.04 Median $478.63 Typical High $1,122.02 | Professional | None | $257.04 | $478.63 | $1,122.02 |
Florida Blue Setting Facility Modifier None Typical Low $489.78 Median $1,071.52 Typical High $11,748.98 | Facility | None | $489.78 | $1,071.52 | $11,748.98 |
Florida Blue Setting Professional Modifier None Typical Low $354.81 Median $371.54 Typical High $588.84 | Professional | None | $354.81 | $371.54 | $588.84 |
Molina Setting Professional Modifier None Typical Low $67.61 Median $426.58 Typical High $645.65 | Professional | None | $67.61 | $426.58 | $645.65 |
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 $257.04 Median $575.44 Typical High $1,513.56 | Professional | None | $257.04 | $575.44 | $1,513.56 |
Wellpoint Setting Professional Modifier None Typical Low $234.42 Median $380.19 Typical High $380.19 | Professional | None | $234.42 | $380.19 | $380.19 |
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 $223.87 Median $251.19 Typical High $346.74 | Professional | 52 · Reduced service | $223.87 | $251.19 | $346.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $102.33 Typical High $138.04 | Professional | 53 · Discontinued | $91.20 | $102.33 | $138.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $338.84 Median $380.19 Typical High $512.86 | Professional | 54 · Surgery only | $338.84 | $380.19 | $512.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $75.86 Typical High $104.71 | Professional | 55 · Aftercare only | $67.61 | $75.86 | $104.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $51.29 Typical High $69.18 | Professional | 56 · Pre-op care only | $45.71 | $51.29 | $69.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $316.23 Median $354.81 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $316.23 | $354.81 | $478.63 |
Where Florida sits
The same service costs 4.3 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· 47th of 51
$562
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.