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 $162.18 Median $3,311.31 Typical High $12,022.64 | Facility | None | $162.18 | $3,311.31 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $100.00 Median $162.18 Typical High $269.15 | Professional | None | $100.00 | $162.18 | $269.15 |
Ambetter Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $467.74 | Professional | None | $467.74 | $467.74 | $467.74 |
AvMed Setting Facility Modifier None Typical Low $281.84 Median $2,137.96 Typical High $11,748.98 | Facility | None | $281.84 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $141.25 Median $257.04 Typical High $371.54 | Professional | None | $141.25 | $257.04 | $371.54 |
Cigna Setting Facility Modifier None Typical Low $288.40 Median $457.09 Typical High $2,691.53 | Facility | None | $288.40 | $457.09 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $128.82 Median $218.78 Typical High $316.23 | Professional | None | $128.82 | $218.78 | $316.23 |
Florida Blue Setting Facility Modifier None Typical Low $199.53 Median $436.52 Typical High $4,466.84 | Facility | None | $199.53 | $436.52 | $4,466.84 |
Florida Blue Setting Professional Modifier None Typical Low $93.33 Median $154.88 Typical High $398.11 | Professional | None | $93.33 | $154.88 | $398.11 |
Molina Setting Professional Modifier None Typical Low $27.54 Median $269.15 Typical High $630.96 | Professional | None | $27.54 | $269.15 | $630.96 |
United Setting Facility Modifier None Typical Low $281.84 Median $660.69 Typical High $4,073.80 | Facility | None | $281.84 | $660.69 | $4,073.80 |
United Setting Professional Modifier None Typical Low $104.71 Median $177.83 Typical High $323.59 | Professional | None | $104.71 | $177.83 | $323.59 |
Wellpoint Setting Professional Modifier None Typical Low $141.25 Median $218.78 Typical High $218.78 | Professional | None | $141.25 | $218.78 | $218.78 |
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 $48.98 Median $81.28 Typical High $107.15 | Professional | 52 · Reduced service | $48.98 | $81.28 | $107.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.95 Median $32.36 Typical High $43.65 | Professional | 53 · Discontinued | $19.95 | $32.36 | $43.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $74.13 Median $120.23 Typical High $162.18 | Professional | 54 · Surgery only | $74.13 | $120.23 | $162.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.79 Median $23.99 Typical High $32.36 | Professional | 55 · Aftercare only | $14.79 | $23.99 | $32.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.00 Median $16.22 Typical High $21.88 | Professional | 56 · Pre-op care only | $10.00 | $16.22 | $21.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $69.18 Median $112.20 Typical High $151.36 | Professional | 78 · Unplanned return to OR | $69.18 | $112.20 | $151.36 |
Where Florida sits
The same service costs 4.5 times more in Alaska than in Kentucky. 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· 44th of 51
$214
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.