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 $194.98 Median $3,090.30 Typical High $11,481.54 | Facility | None | $194.98 | $3,090.30 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $165.96 Median $194.98 Typical High $323.59 | Professional | None | $165.96 | $194.98 | $323.59 |
Ambetter Setting Professional Modifier None Typical Low $186.21 Median $251.19 Typical High $263.03 | Professional | None | $186.21 | $251.19 | $263.03 |
AvMed Setting Facility Modifier None Typical Low $288.40 Median $1,905.46 Typical High $9,549.93 | Facility | None | $288.40 | $1,905.46 | $9,549.93 |
AvMed Setting Professional Modifier None Typical Low $204.17 Median $229.09 Typical High $295.12 | Professional | None | $204.17 | $229.09 | $295.12 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $1,318.26 Typical High $2,691.53 | Facility | None | $501.19 | $1,318.26 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $162.18 Median $229.09 Typical High $436.52 | Professional | None | $162.18 | $229.09 | $436.52 |
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 $162.18 Median $190.55 Typical High $263.03 | Professional | None | $162.18 | $190.55 | $263.03 |
Molina Setting Professional Modifier None Typical Low $173.78 Median $263.03 Typical High $524.81 | Professional | None | $173.78 | $263.03 | $524.81 |
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 $154.88 Median $251.19 Typical High $489.78 | Professional | None | $154.88 | $251.19 | $489.78 |
Wellpoint Setting Professional Modifier None Typical Low $147.91 Median $213.80 Typical High $213.80 | Professional | None | $147.91 | $213.80 | $213.80 |
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 $83.18 Median $91.20 Typical High $125.89 | Professional | 52 · Reduced service | $83.18 | $91.20 | $125.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.11 Median $37.15 Typical High $50.12 | Professional | 53 · Discontinued | $33.11 | $37.15 | $50.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $123.03 Median $138.04 Typical High $190.55 | Professional | 54 · Surgery only | $123.03 | $138.04 | $190.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $27.54 Typical High $38.02 | Professional | 55 · Aftercare only | $24.55 | $27.54 | $38.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $18.20 Typical High $25.12 | Professional | 56 · Pre-op care only | $16.60 | $18.20 | $25.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $114.82 Median $128.82 Typical High $177.83 | Professional | 78 · Unplanned return to OR | $114.82 | $128.82 | $177.83 |
Where Florida sits
The same service costs 4.7 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· 31st of 51
$316
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.