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 $524.81 Median $4,365.16 Typical High $11,748.98 | Facility | None | $524.81 | $4,365.16 | $11,748.98 |
Aetna Setting Professional Modifier None Typical Low $239.88 Median $269.15 Typical High $346.74 | Professional | None | $239.88 | $269.15 | $346.74 |
Ambetter Setting Professional Modifier None Typical Low $239.88 Median $239.88 Typical High $281.84 | Professional | None | $239.88 | $239.88 | $281.84 |
AvMed Setting Facility Modifier None Typical Low $501.19 Median $2,137.96 Typical High $9,772.37 | Facility | None | $501.19 | $2,137.96 | $9,772.37 |
AvMed Setting Professional Modifier None Typical Low $213.80 Median $269.15 Typical High $316.23 | Professional | None | $213.80 | $269.15 | $316.23 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $2,951.21 Typical High $5,370.32 | Facility | None | $501.19 | $2,951.21 | $5,370.32 |
Cigna Setting Professional Modifier None Typical Low $208.93 Median $218.78 Typical High $407.38 | Professional | None | $208.93 | $218.78 | $407.38 |
Florida Blue Setting Facility Modifier None Typical Low $1,071.52 Median $2,089.30 Typical High $16,982.44 | Facility | None | $1,071.52 | $2,089.30 | $16,982.44 |
Florida Blue Setting Professional Modifier None Typical Low $134.90 Median $288.40 Typical High $316.23 | Professional | None | $134.90 | $288.40 | $316.23 |
Molina Setting Professional Modifier None Typical Low $158.49 Median $229.09 Typical High $512.86 | Professional | None | $158.49 | $229.09 | $512.86 |
United Setting Facility Modifier None Typical Low $794.33 Median $1,905.46 Typical High $7,585.78 | Facility | None | $794.33 | $1,905.46 | $7,585.78 |
United Setting Professional Modifier None Typical Low $199.53 Median $257.04 Typical High $426.58 | Professional | None | $199.53 | $257.04 | $426.58 |
Wellpoint Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $204.17 | Professional | None | $204.17 | $204.17 | $204.17 |
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 $120.23 Median $134.90 Typical High $154.88 | Professional | 52 · Reduced service | $120.23 | $134.90 | $154.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $47.86 Median $53.70 Typical High $61.66 | Professional | 53 · Discontinued | $47.86 | $53.70 | $61.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $177.83 Median $204.17 Typical High $234.42 | Professional | 54 · Surgery only | $177.83 | $204.17 | $234.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $40.74 Typical High $46.77 | Professional | 55 · Aftercare only | $35.48 | $40.74 | $46.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $26.92 Typical High $30.90 | Professional | 56 · Pre-op care only | $23.99 | $26.92 | $30.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $165.96 Median $190.55 Typical High $218.78 | Professional | 78 · Unplanned return to OR | $165.96 | $190.55 | $218.78 |
Where Florida sits
The same service costs 5.5 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
$251
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.