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 $104.71 Median $158.49 Typical High $239.88 | Professional | None | $104.71 | $158.49 | $239.88 |
Ambetter Setting Professional Modifier None Typical Low $208.93 Median $208.93 Typical High $208.93 | Professional | None | $208.93 | $208.93 | $208.93 |
AvMed Setting Facility Modifier None Typical Low $165.96 Median $2,137.96 Typical High $11,748.98 | Facility | None | $165.96 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $120.23 Median $177.83 Typical High $239.88 | Professional | None | $120.23 | $177.83 | $239.88 |
Cigna Setting Facility Modifier None Typical Low $165.96 Median $302.00 Typical High $1,659.59 | Facility | None | $165.96 | $302.00 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $91.20 Median $158.49 Typical High $251.19 | Professional | None | $91.20 | $158.49 | $251.19 |
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 $91.20 Median $165.96 Typical High $257.04 | Professional | None | $91.20 | $165.96 | $257.04 |
Molina Setting Professional Modifier None Typical Low $27.54 Median $162.18 Typical High $389.05 | Professional | None | $27.54 | $162.18 | $389.05 |
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 $95.50 Median $151.36 Typical High $257.04 | Professional | None | $95.50 | $151.36 | $257.04 |
Wellpoint Setting Professional Modifier None Typical Low $93.33 Median $177.83 Typical High $177.83 | Professional | None | $93.33 | $177.83 | $177.83 |
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 $52.48 Median $79.43 Typical High $100.00 | Professional | 52 · Reduced service | $52.48 | $79.43 | $100.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.89 Median $31.62 Typical High $39.81 | Professional | 53 · Discontinued | $20.89 | $31.62 | $39.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $77.62 Median $120.23 Typical High $151.36 | Professional | 54 · Surgery only | $77.62 | $120.23 | $151.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.49 Median $23.99 Typical High $30.20 | Professional | 55 · Aftercare only | $15.49 | $23.99 | $30.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $15.85 Typical High $19.95 | Professional | 56 · Pre-op care only | $10.47 | $15.85 | $19.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $72.44 Median $112.20 Typical High $141.25 | Professional | 78 · Unplanned return to OR | $72.44 | $112.20 | $141.25 |
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· 49th of 51
$162
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.