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 $114.82 Median $3,311.31 Typical High $12,022.64 | Facility | None | $114.82 | $3,311.31 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $91.20 Median $117.49 Typical High $169.82 | Professional | None | $91.20 | $117.49 | $169.82 |
Ambetter Setting Professional Modifier None Typical Low $114.82 Median $134.90 Typical High $134.90 | Professional | None | $114.82 | $134.90 | $134.90 |
AvMed Setting Facility Modifier None Typical Low $120.23 Median $2,137.96 Typical High $11,748.98 | Facility | None | $120.23 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $102.33 Median $120.23 Typical High $154.88 | Professional | None | $102.33 | $120.23 | $154.88 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $66.07 Typical High $724.44 | Facility | None | $50.12 | $66.07 | $724.44 |
Cigna Setting Professional Modifier None Typical Low $81.28 Median $123.03 Typical High $239.88 | Professional | None | $81.28 | $123.03 | $239.88 |
Florida Blue Setting Facility Modifier None Typical Low $34.67 Median $74.13 Typical High $3,019.95 | Facility | None | $34.67 | $74.13 | $3,019.95 |
Florida Blue Setting Professional Modifier None Typical Low $95.50 Median $107.15 Typical High $141.25 | Professional | None | $95.50 | $107.15 | $141.25 |
Molina Setting Professional Modifier None Typical Low $85.11 Median $125.89 Typical High $245.47 | Professional | None | $85.11 | $125.89 | $245.47 |
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 $83.18 Median $134.90 Typical High $275.42 | Professional | None | $83.18 | $134.90 | $275.42 |
Wellpoint Setting Professional Modifier None Typical Low $79.43 Median $112.20 Typical High $112.20 | Professional | None | $79.43 | $112.20 | $112.20 |
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 $43.65 Median $54.95 Typical High $72.44 | Professional | 52 · Reduced service | $43.65 | $54.95 | $72.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.78 Median $21.88 Typical High $29.51 | Professional | 53 · Discontinued | $17.78 | $21.88 | $29.51 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $66.07 Median $81.28 Typical High $109.65 | Professional | 54 · Surgery only | $66.07 | $81.28 | $109.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.18 Median $16.60 Typical High $21.88 | Professional | 55 · Aftercare only | $13.18 | $16.60 | $21.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.71 Median $10.96 Typical High $14.79 | Professional | 56 · Pre-op care only | $8.71 | $10.96 | $14.79 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $61.66 Median $75.86 Typical High $102.33 | Professional | 78 · Unplanned return to OR | $61.66 | $75.86 | $102.33 |
Where Florida sits
The same service costs 4.1 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· 50th of 51
$123
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.