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 $109.65 Median $173.78 Typical High $245.47 | Professional | None | $109.65 | $173.78 | $245.47 |
Ambetter Setting Professional Modifier None Typical Low $223.87 Median $223.87 Typical High $223.87 | Professional | None | $223.87 | $223.87 | $223.87 |
AvMed Setting Facility Modifier None Typical Low $194.98 Median $2,137.96 Typical High $11,748.98 | Facility | None | $194.98 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $134.90 Median $213.80 Typical High $275.42 | Professional | None | $134.90 | $213.80 | $275.42 |
Cigna Setting Facility Modifier None Typical Low $194.98 Median $309.03 Typical High $1,659.59 | Facility | None | $194.98 | $309.03 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $97.72 Median $165.96 Typical High $263.03 | Professional | None | $97.72 | $165.96 | $263.03 |
Florida Blue Setting Facility Modifier None Typical Low $120.23 Median $251.19 Typical High $3,981.07 | Facility | None | $120.23 | $251.19 | $3,981.07 |
Florida Blue Setting Professional Modifier None Typical Low $97.72 Median $177.83 Typical High $302.00 | Professional | None | $97.72 | $177.83 | $302.00 |
Molina Setting Professional Modifier None Typical Low $27.54 Median $190.55 Typical High $467.74 | Professional | None | $27.54 | $190.55 | $467.74 |
United Setting Facility Modifier None Typical Low $81.28 Median $302.00 Typical High $2,818.38 | Facility | None | $81.28 | $302.00 | $2,818.38 |
United Setting Professional Modifier None Typical Low $100.00 Median $162.18 Typical High $269.15 | Professional | None | $100.00 | $162.18 | $269.15 |
Wellpoint Setting Professional Modifier None Typical Low $102.33 Median $204.17 Typical High $204.17 | Professional | None | $102.33 | $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 $54.95 Median $87.10 Typical High $109.65 | Professional | 52 · Reduced service | $54.95 | $87.10 | $109.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $34.67 Typical High $43.65 | Professional | 53 · Discontinued | $21.88 | $34.67 | $43.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $81.28 Median $128.82 Typical High $165.96 | Professional | 54 · Surgery only | $81.28 | $128.82 | $165.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $25.70 Typical High $33.11 | Professional | 55 · Aftercare only | $16.60 | $25.70 | $33.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $17.38 Typical High $21.88 | Professional | 56 · Pre-op care only | $10.96 | $17.38 | $21.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $75.86 Median $120.23 Typical High $154.88 | Professional | 78 · Unplanned return to OR | $75.86 | $120.23 | $154.88 |
Where Florida sits
The same service costs 3.5 times more in Alaska than in Washington, DC. 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· 48th of 51
$174
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.