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 $660.69 Median $5,495.41 Typical High $12,022.64 | Facility | None | $660.69 | $5,495.41 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $616.60 Median $660.69 Typical High $851.14 | Professional | None | $616.60 | $660.69 | $851.14 |
Ambetter Setting Professional Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $1,288.25 | Professional | None | $1,288.25 | $1,288.25 | $1,288.25 |
AvMed Setting Facility Modifier None Typical Low $549.54 Median $2,137.96 Typical High $11,748.98 | Facility | None | $549.54 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $549.54 Median $724.44 Typical High $812.83 | Professional | None | $549.54 | $724.44 | $812.83 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $501.19 Typical High $2,691.53 | Facility | None | $398.11 | $501.19 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $501.19 Median $724.44 Typical High $1,380.38 | Professional | None | $501.19 | $724.44 | $1,380.38 |
Florida Blue Setting Facility Modifier None Typical Low $10,471.29 Median $22,387.21 Typical High $33,884.42 | Facility | None | $10,471.29 | $22,387.21 | $33,884.42 |
Florida Blue Setting Professional Modifier None Typical Low $467.74 Median $501.19 Typical High $758.58 | Professional | None | $467.74 | $501.19 | $758.58 |
Molina Setting Professional Modifier None Typical Low $79.43 Median $630.96 Typical High $1,230.27 | Professional | None | $79.43 | $630.96 | $1,230.27 |
United Setting Facility Modifier None Typical Low $794.33 Median $1,737.80 Typical High $7,585.78 | Facility | None | $794.33 | $1,737.80 | $7,585.78 |
United Setting Professional Modifier None Typical Low $60.26 Median $794.33 Typical High $1,479.11 | Professional | None | $60.26 | $794.33 | $1,479.11 |
Wellpoint Setting Professional Modifier None Typical Low $501.19 Median $501.19 Typical High $660.69 | Professional | None | $501.19 | $501.19 | $660.69 |
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 $309.03 Median $331.13 Typical High $416.87 | Professional | 52 · Reduced service | $309.03 | $331.13 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $131.83 Typical High $165.96 | Professional | 53 · Discontinued | $123.03 | $131.83 | $165.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $489.78 Typical High $616.60 | Professional | 54 · Surgery only | $467.74 | $489.78 | $616.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $100.00 Typical High $125.89 | Professional | 55 · Aftercare only | $93.33 | $100.00 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $66.07 Typical High $83.18 | Professional | 56 · Pre-op care only | $61.66 | $66.07 | $83.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $457.09 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $436.52 | $457.09 | $588.84 |
Where Florida sits
The same service costs 5.4 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
$708
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.