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 $478.63 Median $3,801.89 Typical High $10,964.78 | Facility | None | $478.63 | $3,801.89 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $239.88 Median $309.03 Typical High $446.68 | Professional | None | $239.88 | $309.03 | $446.68 |
Ambetter Setting Professional Modifier None Typical Low $426.58 Median $426.58 Typical High $426.58 | Professional | None | $426.58 | $426.58 | $426.58 |
AvMed Setting Facility Modifier None Typical Low $398.11 Median $1,479.11 Typical High $9,549.93 | Facility | None | $398.11 | $1,479.11 | $9,549.93 |
AvMed Setting Professional Modifier None Typical Low $275.42 Median $331.13 Typical High $416.87 | Professional | None | $275.42 | $331.13 | $416.87 |
Cigna Setting Facility Modifier None Typical Low $436.52 Median $1,698.24 Typical High $2,754.23 | Facility | None | $436.52 | $1,698.24 | $2,754.23 |
Cigna Setting Professional Modifier None Typical Low $208.93 Median $331.13 Typical High $630.96 | Professional | None | $208.93 | $331.13 | $630.96 |
Florida Blue Setting Facility Modifier None Typical Low $660.69 Median $1,318.26 Typical High $16,982.44 | Facility | None | $660.69 | $1,318.26 | $16,982.44 |
Florida Blue Setting Professional Modifier None Typical Low $257.04 Median $281.84 Typical High $363.08 | Professional | None | $257.04 | $281.84 | $363.08 |
Molina Setting Professional Modifier None Typical Low $34.67 Median $323.59 Typical High $660.69 | Professional | None | $34.67 | $323.59 | $660.69 |
United Setting Facility Modifier None Typical Low $794.33 Median $1,778.28 Typical High $7,585.78 | Facility | None | $794.33 | $1,778.28 | $7,585.78 |
United Setting Professional Modifier None Typical Low $223.87 Median $371.54 Typical High $741.31 | Professional | None | $223.87 | $371.54 | $741.31 |
Wellpoint Setting Professional Modifier None Typical Low $204.17 Median $295.12 Typical High $295.12 | Professional | None | $204.17 | $295.12 | $295.12 |
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 $120.23 Median $144.54 Typical High $194.98 | Professional | 52 · Reduced service | $120.23 | $144.54 | $194.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $47.86 Median $57.54 Typical High $77.62 | Professional | 53 · Discontinued | $47.86 | $57.54 | $77.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $177.83 Median $218.78 Typical High $288.40 | Professional | 54 · Surgery only | $177.83 | $218.78 | $288.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $43.65 Typical High $57.54 | Professional | 55 · Aftercare only | $35.48 | $43.65 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $28.84 Typical High $38.90 | Professional | 56 · Pre-op care only | $23.99 | $28.84 | $38.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $165.96 Median $204.17 Typical High $269.15 | Professional | 78 · Unplanned return to OR | $165.96 | $204.17 | $269.15 |
Where Florida sits
The same service costs 4.9 times more in Alaska 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· 43rd of 51
$398
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.