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 $3,801.89 Typical High $10,964.78 | Facility | None | $478.63 | $3,801.89 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $162.18 Median $181.97 Typical High $239.88 | Professional | None | $162.18 | $181.97 | $239.88 |
Ambetter Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $204.17 | Professional | None | $204.17 | $204.17 | $204.17 |
AvMed Setting Facility Modifier None Typical Low $245.47 Median $1,698.24 Typical High $9,549.93 | Facility | None | $245.47 | $1,698.24 | $9,549.93 |
AvMed Setting Professional Modifier None Typical Low $181.97 Median $213.80 Typical High $245.47 | Professional | None | $181.97 | $213.80 | $245.47 |
Cigna Setting Facility Modifier None Typical Low $436.52 Median $1,949.84 Typical High $3,019.95 | Facility | None | $436.52 | $1,949.84 | $3,019.95 |
Cigna Setting Professional Modifier None Typical Low $138.04 Median $194.98 Typical High $380.19 | Professional | None | $138.04 | $194.98 | $380.19 |
Florida Blue Setting Facility Modifier None Typical Low $891.25 Median $1,737.80 Typical High $16,982.44 | Facility | None | $891.25 | $1,737.80 | $16,982.44 |
Florida Blue Setting Professional Modifier None Typical Low $154.88 Median $165.96 Typical High $295.12 | Professional | None | $154.88 | $165.96 | $295.12 |
Molina Setting Professional Modifier None Typical Low $114.82 Median $181.97 Typical High $354.81 | Professional | None | $114.82 | $181.97 | $354.81 |
United Setting Facility Modifier None Typical Low $794.33 Median $1,778.28 Typical High $7,585.78 | Facility | None | $794.33 | $1,778.28 | $7,585.78 |
United Setting Professional Modifier None Typical Low $141.25 Median $223.87 Typical High $416.87 | Professional | None | $141.25 | $223.87 | $416.87 |
Wellpoint Setting Professional Modifier None Typical Low $131.83 Median $169.82 Typical High $169.82 | Professional | None | $131.83 | $169.82 | $169.82 |
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 $81.28 Median $91.20 Typical High $112.20 | Professional | 52 · Reduced service | $81.28 | $91.20 | $112.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.11 Median $36.31 Typical High $44.67 | Professional | 53 · Discontinued | $33.11 | $36.31 | $44.67 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $123.03 Median $138.04 Typical High $169.82 | Professional | 54 · Surgery only | $123.03 | $138.04 | $169.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $27.54 Typical High $33.88 | Professional | 55 · Aftercare only | $24.55 | $27.54 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $18.20 Typical High $22.39 | Professional | 56 · Pre-op care only | $16.22 | $18.20 | $22.39 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $114.82 Median $128.82 Typical High $158.49 | Professional | 78 · Unplanned return to OR | $114.82 | $128.82 | $158.49 |
Where Florida sits
The same service costs 5.9 times more in Oklahoma 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· 35th of 51
$257
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.