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 $85.11 Median $151.36 Typical High $229.09 | Professional | None | $85.11 | $151.36 | $229.09 |
Ambetter Setting Professional Modifier None Typical Low $186.21 Median $186.21 Typical High $199.53 | Professional | None | $186.21 | $186.21 | $199.53 |
AvMed Setting Facility Modifier None Typical Low $223.87 Median $1,288.25 Typical High $9,549.93 | Facility | None | $223.87 | $1,288.25 | $9,549.93 |
AvMed Setting Professional Modifier None Typical Low $102.33 Median $165.96 Typical High $223.87 | Professional | None | $102.33 | $165.96 | $223.87 |
Cigna Setting Facility Modifier None Typical Low $323.59 Median $776.25 Typical High $1,659.59 | Facility | None | $323.59 | $776.25 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $77.62 Median $151.36 Typical High $229.09 | Professional | None | $77.62 | $151.36 | $229.09 |
Florida Blue Setting Facility Modifier None Typical Low $380.19 Median $776.25 Typical High $6,309.57 | Facility | None | $380.19 | $776.25 | $6,309.57 |
Florida Blue Setting Professional Modifier None Typical Low $87.10 Median $141.25 Typical High $239.88 | Professional | None | $87.10 | $141.25 | $239.88 |
Molina Setting Professional Modifier None Typical Low $26.92 Median $138.04 Typical High $338.84 | Professional | None | $26.92 | $138.04 | $338.84 |
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 $77.62 Median $138.04 Typical High $234.42 | Professional | None | $77.62 | $138.04 | $234.42 |
Wellpoint Setting Professional Modifier None Typical Low $79.43 Median $162.18 Typical High $162.18 | Professional | None | $79.43 | $162.18 | $162.18 |
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 $42.66 Median $75.86 Typical High $93.33 | Professional | 52 · Reduced service | $42.66 | $75.86 | $93.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.38 Median $30.20 Typical High $37.15 | Professional | 53 · Discontinued | $17.38 | $30.20 | $37.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $64.57 Median $112.20 Typical High $138.04 | Professional | 54 · Surgery only | $64.57 | $112.20 | $138.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $22.91 Typical High $27.54 | Professional | 55 · Aftercare only | $12.88 | $22.91 | $27.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $15.14 Typical High $18.62 | Professional | 56 · Pre-op care only | $8.51 | $15.14 | $18.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $60.26 Median $104.71 Typical High $128.82 | Professional | 78 · Unplanned return to OR | $60.26 | $104.71 | $128.82 |
Where Florida sits
The same service costs 3.3 times more in Alaska than in Washington, DC. 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
$151
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.