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 $190.55 Median $2,951.21 Typical High $10,964.78 | Facility | None | $190.55 | $2,951.21 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $141.25 Median $181.97 Typical High $275.42 | Professional | None | $141.25 | $181.97 | $275.42 |
Ambetter Setting Professional Modifier None Typical Low $72.44 Median $177.83 Typical High $331.13 | Professional | None | $72.44 | $177.83 | $331.13 |
AvMed Setting Facility Modifier None Typical Low $239.88 Median $1,288.25 Typical High $9,549.93 | Facility | None | $239.88 | $1,288.25 | $9,549.93 |
AvMed Setting Professional Modifier None Typical Low $158.49 Median $194.98 Typical High $239.88 | Professional | None | $158.49 | $194.98 | $239.88 |
Cigna Setting Facility Modifier None Typical Low $323.59 Median $1,288.25 Typical High $2,089.30 | Facility | None | $323.59 | $1,288.25 | $2,089.30 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $190.55 Typical High $371.54 | Professional | None | $125.89 | $190.55 | $371.54 |
Florida Blue Setting Facility Modifier None Typical Low $831.76 Median $1,819.70 Typical High $7,413.10 | Facility | None | $831.76 | $1,819.70 | $7,413.10 |
Florida Blue Setting Professional Modifier None Typical Low $154.88 Median $165.96 Typical High $275.42 | Professional | None | $154.88 | $165.96 | $275.42 |
Molina Setting Professional Modifier None Typical Low $138.04 Median $199.53 Typical High $398.11 | Professional | None | $138.04 | $199.53 | $398.11 |
United Setting Facility Modifier None Typical Low $398.11 Median $1,000.00 Typical High $5,623.41 | Facility | None | $398.11 | $1,000.00 | $5,623.41 |
United Setting Professional Modifier None Typical Low $128.82 Median $213.80 Typical High $426.58 | Professional | None | $128.82 | $213.80 | $426.58 |
Wellpoint Setting Professional Modifier None Typical Low $120.23 Median $173.78 Typical High $173.78 | Professional | None | $120.23 | $173.78 | $173.78 |
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 $70.79 Median $89.13 Typical High $114.82 | Professional | 52 · Reduced service | $70.79 | $89.13 | $114.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $35.48 Typical High $45.71 | Professional | 53 · Discontinued | $28.18 | $35.48 | $45.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $104.71 Median $131.83 Typical High $169.82 | Professional | 54 · Surgery only | $104.71 | $131.83 | $169.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $26.30 Typical High $33.88 | Professional | 55 · Aftercare only | $20.89 | $26.30 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $17.78 Typical High $22.91 | Professional | 56 · Pre-op care only | $14.13 | $17.78 | $22.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $97.72 Median $123.03 Typical High $158.49 | Professional | 78 · Unplanned return to OR | $97.72 | $123.03 | $158.49 |
Where Florida sits
The same service costs 4.6 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· 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.