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 $3,090.30 Typical High $10,964.78 | Facility | None | $478.63 | $3,090.30 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $218.78 Median $275.42 Typical High $371.54 | Professional | None | $218.78 | $275.42 | $371.54 |
Ambetter Setting Professional Modifier None Typical Low $354.81 Median $436.52 Typical High $436.52 | Professional | None | $354.81 | $436.52 | $436.52 |
AvMed Setting Facility Modifier None Typical Low $380.19 Median $1,479.11 Typical High $9,549.93 | Facility | None | $380.19 | $1,479.11 | $9,549.93 |
AvMed Setting Professional Modifier None Typical Low $245.47 Median $309.03 Typical High $398.11 | Professional | None | $245.47 | $309.03 | $398.11 |
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 $186.21 Median $251.19 Typical High $436.52 | Professional | None | $186.21 | $251.19 | $436.52 |
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 $158.49 Median $269.15 Typical High $416.87 | Professional | None | $158.49 | $269.15 | $416.87 |
Molina Setting Professional Modifier None Typical Low $26.92 Median $245.47 Typical High $616.60 | Professional | None | $26.92 | $245.47 | $616.60 |
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 $199.53 Median $275.42 Typical High $457.09 | Professional | None | $199.53 | $275.42 | $457.09 |
Wellpoint Setting Professional Modifier None Typical Low $190.55 Median $288.40 Typical High $288.40 | Professional | None | $190.55 | $288.40 | $288.40 |
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 $109.65 Median $138.04 Typical High $169.82 | Professional | 52 · Reduced service | $109.65 | $138.04 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $43.65 Median $54.95 Typical High $67.61 | Professional | 53 · Discontinued | $43.65 | $54.95 | $67.61 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $165.96 Median $208.93 Typical High $257.04 | Professional | 54 · Surgery only | $165.96 | $208.93 | $257.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.11 Median $41.69 Typical High $51.29 | Professional | 55 · Aftercare only | $33.11 | $41.69 | $51.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $27.54 Typical High $33.88 | Professional | 56 · Pre-op care only | $21.88 | $27.54 | $33.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $154.88 Median $194.98 Typical High $239.88 | Professional | 78 · Unplanned return to OR | $154.88 | $194.98 | $239.88 |
Where Florida sits
The same service costs 4.1 times more in Alaska than in New Jersey. 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· 50th of 51
$269
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.