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 $87.10 Median $114.82 Typical High $169.82 | Professional | None | $87.10 | $114.82 | $169.82 |
Ambetter Setting Professional Modifier None Typical Low $128.82 Median $177.83 Typical High $177.83 | Professional | None | $128.82 | $177.83 | $177.83 |
AvMed Setting Facility Modifier None Typical Low $112.20 Median $2,137.96 Typical High $11,748.98 | Facility | None | $112.20 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $102.33 Median $123.03 Typical High $162.18 | Professional | None | $102.33 | $123.03 | $162.18 |
Cigna Setting Facility Modifier None Typical Low $97.72 Median $194.98 Typical High $1,659.59 | Facility | None | $97.72 | $194.98 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $77.62 Median $104.71 Typical High $181.97 | Professional | None | $77.62 | $104.71 | $181.97 |
Florida Blue Setting Facility Modifier None Typical Low $114.82 Median $251.19 Typical High $6,309.57 | Facility | None | $114.82 | $251.19 | $6,309.57 |
Florida Blue Setting Professional Modifier None Typical Low $64.57 Median $131.83 Typical High $169.82 | Professional | None | $64.57 | $131.83 | $169.82 |
Molina Setting Professional Modifier None Typical Low $77.62 Median $107.15 Typical High $245.47 | Professional | None | $77.62 | $107.15 | $245.47 |
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 $79.43 Median $109.65 Typical High $181.97 | Professional | None | $79.43 | $109.65 | $181.97 |
Wellpoint Setting Professional Modifier None Typical Low $79.43 Median $117.49 Typical High $117.49 | Professional | None | $79.43 | $117.49 | $117.49 |
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 $43.65 Median $57.54 Typical High $69.18 | Professional | 52 · Reduced service | $43.65 | $57.54 | $69.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.38 Median $22.91 Typical High $27.54 | Professional | 53 · Discontinued | $17.38 | $22.91 | $27.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $64.57 Median $85.11 Typical High $104.71 | Professional | 54 · Surgery only | $64.57 | $85.11 | $104.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $16.98 Typical High $20.89 | Professional | 55 · Aftercare only | $12.88 | $16.98 | $20.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.71 Median $11.48 Typical High $13.80 | Professional | 56 · Pre-op care only | $8.71 | $11.48 | $13.80 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $60.26 Median $79.43 Typical High $97.72 | Professional | 78 · Unplanned return to OR | $60.26 | $79.43 | $97.72 |
Where Florida sits
The same service costs 4.0 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
$112
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.