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 $186.21 Median $234.42 Typical High $323.59 | Professional | None | $186.21 | $234.42 | $323.59 |
Ambetter Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $281.84 | Professional | None | $281.84 | $281.84 | $281.84 |
AvMed Setting Facility Modifier None Typical Low $338.84 Median $1,479.11 Typical High $9,549.93 | Facility | None | $338.84 | $1,479.11 | $9,549.93 |
AvMed Setting Professional Modifier None Typical Low $204.17 Median $257.04 Typical High $338.84 | Professional | None | $204.17 | $257.04 | $338.84 |
Cigna Setting Facility Modifier None Typical Low $436.52 Median $776.25 Typical High $2,187.76 | Facility | None | $436.52 | $776.25 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $162.18 Median $218.78 Typical High $363.08 | Professional | None | $162.18 | $218.78 | $363.08 |
Florida Blue Setting Facility Modifier None Typical Low $1,000.00 Median $2,187.76 Typical High $6,309.57 | Facility | None | $1,000.00 | $2,187.76 | $6,309.57 |
Florida Blue Setting Professional Modifier None Typical Low $134.90 Median $251.19 Typical High $354.81 | Professional | None | $134.90 | $251.19 | $354.81 |
Molina Setting Professional Modifier None Typical Low $26.92 Median $199.53 Typical High $478.63 | Professional | None | $26.92 | $199.53 | $478.63 |
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 $165.96 Median $229.09 Typical High $380.19 | Professional | None | $165.96 | $229.09 | $380.19 |
Wellpoint Setting Professional Modifier None Typical Low $158.49 Median $239.88 Typical High $239.88 | Professional | None | $158.49 | $239.88 | $239.88 |
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 $93.33 Median $117.49 Typical High $144.54 | Professional | 52 · Reduced service | $93.33 | $117.49 | $144.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $46.77 Typical High $57.54 | Professional | 53 · Discontinued | $37.15 | $46.77 | $57.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $177.83 Typical High $218.78 | Professional | 54 · Surgery only | $138.04 | $177.83 | $218.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $35.48 Typical High $43.65 | Professional | 55 · Aftercare only | $27.54 | $35.48 | $43.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $23.44 Typical High $28.84 | Professional | 56 · Pre-op care only | $18.62 | $23.44 | $28.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $128.82 Median $165.96 Typical High $204.17 | Professional | 78 · Unplanned return to OR | $128.82 | $165.96 | $204.17 |
Where Florida sits
The same service costs 4.3 times more in Alaska than in Utah. 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
$229
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.