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 $776.25 Median $4,786.30 Typical High $11,748.98 | Facility | None | $776.25 | $4,786.30 | $11,748.98 |
Aetna Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $1,230.27 | Professional | None | $851.14 | $851.14 | $1,230.27 |
Ambetter Setting Professional Modifier None Typical Low $1,584.89 Median $1,584.89 Typical High $1,584.89 | Professional | None | $1,584.89 | $1,584.89 | $1,584.89 |
AvMed Setting Facility Modifier None Typical Low $724.44 Median $2,089.30 Typical High $9,772.37 | Facility | None | $724.44 | $2,089.30 | $9,772.37 |
AvMed Setting Professional Modifier None Typical Low $741.31 Median $1,000.00 Typical High $1,096.48 | Professional | None | $741.31 | $1,000.00 | $1,096.48 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $1,995.26 Typical High $3,090.30 | Facility | None | $501.19 | $1,995.26 | $3,090.30 |
Cigna Setting Professional Modifier None Typical Low $691.83 Median $977.24 Typical High $1,862.09 | Professional | None | $691.83 | $977.24 | $1,862.09 |
Florida Blue Setting Facility Modifier None Typical Low $1,230.27 Median $2,630.27 Typical High $16,982.44 | Facility | None | $1,230.27 | $2,630.27 | $16,982.44 |
Florida Blue Setting Professional Modifier None Typical Low $630.96 Median $676.08 Typical High $1,122.02 | Professional | None | $630.96 | $676.08 | $1,122.02 |
Molina Setting Professional Modifier None Typical Low $104.71 Median $794.33 Typical High $1,584.89 | Professional | None | $104.71 | $794.33 | $1,584.89 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $3,311.31 Typical High $12,589.25 | Facility | None | $1,230.27 | $3,311.31 | $12,589.25 |
United Setting Professional Modifier None Typical Low $60.26 Median $1,071.52 Typical High $2,041.74 | Professional | None | $60.26 | $1,071.52 | $2,041.74 |
Wellpoint Setting Professional Modifier None Typical Low $676.08 Median $676.08 Typical High $891.25 | Professional | None | $676.08 | $676.08 | $891.25 |
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 $426.58 Median $426.58 Typical High $575.44 | Professional | 52 · Reduced service | $426.58 | $426.58 | $575.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $169.82 Typical High $229.09 | Professional | 53 · Discontinued | $169.82 | $169.82 | $229.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $645.65 Typical High $870.96 | Professional | 54 · Surgery only | $630.96 | $645.65 | $870.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $128.82 Typical High $173.78 | Professional | 55 · Aftercare only | $125.89 | $128.82 | $173.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $85.11 Typical High $114.82 | Professional | 56 · Pre-op care only | $85.11 | $85.11 | $114.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $602.56 Typical High $812.83 | Professional | 78 · Unplanned return to OR | $588.84 | $602.56 | $812.83 |
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· 47th of 51
$1,023
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.