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 $141.25 Median $194.98 Typical High $309.03 | Professional | None | $141.25 | $194.98 | $309.03 |
Ambetter Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $147.91 | Professional | None | $147.91 | $147.91 | $147.91 |
AvMed Setting Facility Modifier None Typical Low $194.98 Median $2,137.96 Typical High $11,748.98 | Facility | None | $194.98 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $158.49 Median $208.93 Typical High $269.15 | Professional | None | $158.49 | $208.93 | $269.15 |
Cigna Setting Facility Modifier None Typical Low $199.53 Median $316.23 Typical High $1,659.59 | Facility | None | $199.53 | $316.23 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $120.23 Median $204.17 Typical High $416.87 | Professional | None | $120.23 | $204.17 | $416.87 |
Florida Blue Setting Facility Modifier None Typical Low $199.53 Median $426.58 Typical High $16,982.44 | Facility | None | $199.53 | $426.58 | $16,982.44 |
Florida Blue Setting Professional Modifier None Typical Low $125.89 Median $173.78 Typical High $239.88 | Professional | None | $125.89 | $173.78 | $239.88 |
Molina Setting Professional Modifier None Typical Low $31.62 Median $194.98 Typical High $416.87 | Professional | None | $31.62 | $194.98 | $416.87 |
United Setting Facility Modifier None Typical Low $398.11 Median $1,000.00 Typical High $5,623.41 | Facility | None | $398.11 | $1,000.00 | $5,623.41 |
United Setting Professional Modifier None Typical Low $125.89 Median $234.42 Typical High $457.09 | Professional | None | $125.89 | $234.42 | $457.09 |
Wellpoint Setting Professional Modifier None Typical Low $120.23 Median $194.98 Typical High $194.98 | Professional | None | $120.23 | $194.98 | $194.98 |
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 $66.07 Median $97.72 Typical High $134.90 | Professional | 52 · Reduced service | $66.07 | $97.72 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.30 Median $38.90 Typical High $53.70 | Professional | 53 · Discontinued | $26.30 | $38.90 | $53.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $100.00 Median $147.91 Typical High $199.53 | Professional | 54 · Surgery only | $100.00 | $147.91 | $199.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $29.51 Typical High $40.74 | Professional | 55 · Aftercare only | $19.95 | $29.51 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $19.50 Typical High $26.92 | Professional | 56 · Pre-op care only | $13.18 | $19.50 | $26.92 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $93.33 Median $138.04 Typical High $186.21 | Professional | 78 · Unplanned return to OR | $93.33 | $138.04 | $186.21 |
Where Florida sits
The same service costs 4.3 times more in Wisconsin 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
$240
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.