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 $457.09 Median $3,090.30 Typical High $10,964.78 | Facility | None | $457.09 | $3,090.30 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $173.78 Median $234.42 Typical High $323.59 | Professional | None | $173.78 | $234.42 | $323.59 |
Ambetter Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $331.13 | Professional | None | $331.13 | $331.13 | $331.13 |
AvMed Setting Facility Modifier None Typical Low $281.84 Median $1,318.26 Typical High $9,549.93 | Facility | None | $281.84 | $1,318.26 | $9,549.93 |
AvMed Setting Professional Modifier None Typical Low $199.53 Median $257.04 Typical High $331.13 | Professional | None | $199.53 | $257.04 | $331.13 |
Cigna Setting Facility Modifier None Typical Low $288.40 Median $436.52 Typical High $2,187.76 | Facility | None | $288.40 | $436.52 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $144.54 Median $239.88 Typical High $489.78 | Professional | None | $144.54 | $239.88 | $489.78 |
Florida Blue Setting Facility Modifier None Typical Low $363.08 Median $776.25 Typical High $3,981.07 | Facility | None | $363.08 | $776.25 | $3,981.07 |
Florida Blue Setting Professional Modifier None Typical Low $194.98 Median $213.80 Typical High $288.40 | Professional | None | $194.98 | $213.80 | $288.40 |
Molina Setting Professional Modifier None Typical Low $33.88 Median $251.19 Typical High $537.03 | Professional | None | $33.88 | $251.19 | $537.03 |
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 $162.18 Median $281.84 Typical High $562.34 | Professional | None | $162.18 | $281.84 | $562.34 |
Wellpoint Setting Professional Modifier None Typical Low $147.91 Median $239.88 Typical High $239.88 | Professional | None | $147.91 | $239.88 | $239.88 |
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 $87.10 Median $117.49 Typical High $151.36 | Professional | 52 · Reduced service | $87.10 | $117.49 | $151.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $46.77 Typical High $60.26 | Professional | 53 · Discontinued | $34.67 | $46.77 | $60.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $131.83 Median $177.83 Typical High $229.09 | Professional | 54 · Surgery only | $131.83 | $177.83 | $229.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $35.48 Typical High $45.71 | Professional | 55 · Aftercare only | $26.30 | $35.48 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $23.44 Typical High $30.20 | Professional | 56 · Pre-op care only | $17.38 | $23.44 | $30.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $123.03 Median $165.96 Typical High $213.80 | Professional | 78 · Unplanned return to OR | $123.03 | $165.96 | $213.80 |
Where Florida sits
The same service costs 3.7 times more in Wisconsin than in Utah. 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· 42nd of 51
$295
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.