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 $218.78 Median $3,311.31 Typical High $12,022.64 | Facility | None | $218.78 | $3,311.31 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $128.82 Median $186.21 Typical High $275.42 | Professional | None | $128.82 | $186.21 | $275.42 |
Ambetter Setting Professional Modifier None Typical Low $446.68 Median $446.68 Typical High $446.68 | Professional | None | $446.68 | $446.68 | $446.68 |
AvMed Setting Facility Modifier None Typical Low $154.88 Median $2,137.96 Typical High $11,748.98 | Facility | None | $154.88 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $144.54 Median $194.98 Typical High $269.15 | Professional | None | $144.54 | $194.98 | $269.15 |
Cigna Setting Facility Modifier None Typical Low $52.48 Median $141.25 Typical High $281.84 | Facility | None | $52.48 | $141.25 | $281.84 |
Cigna Setting Professional Modifier None Typical Low $107.15 Median $181.97 Typical High $398.11 | Professional | None | $107.15 | $181.97 | $398.11 |
Florida Blue Setting Facility Modifier None Typical Low $114.82 Median $251.19 Typical High $3,019.95 | Facility | None | $114.82 | $251.19 | $3,019.95 |
Florida Blue Setting Professional Modifier None Typical Low $154.88 Median $158.49 Typical High $229.09 | Professional | None | $154.88 | $158.49 | $229.09 |
Molina Setting Professional Modifier None Typical Low $144.54 Median $213.80 Typical High $426.58 | Professional | None | $144.54 | $213.80 | $426.58 |
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 $125.89 Median $234.42 Typical High $457.09 | Professional | None | $125.89 | $234.42 | $457.09 |
Wellpoint Setting Professional Modifier None Typical Low $107.15 Median $181.97 Typical High $181.97 | Professional | None | $107.15 | $181.97 | $181.97 |
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 $63.10 Median $93.33 Typical High $125.89 | Professional | 52 · Reduced service | $63.10 | $93.33 | $125.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $37.15 Typical High $51.29 | Professional | 53 · Discontinued | $25.70 | $37.15 | $51.29 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $95.50 Median $141.25 Typical High $190.55 | Professional | 54 · Surgery only | $95.50 | $141.25 | $190.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $28.18 Typical High $38.02 | Professional | 55 · Aftercare only | $19.05 | $28.18 | $38.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $18.62 Typical High $25.12 | Professional | 56 · Pre-op care only | $12.88 | $18.62 | $25.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $89.13 Median $131.83 Typical High $177.83 | Professional | 78 · Unplanned return to OR | $89.13 | $131.83 | $177.83 |
Where Florida sits
The same service costs 3.7 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· 46th of 51
$209
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.