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 $213.80 Median $3,019.95 Typical High $10,964.78 | Facility | None | $213.80 | $3,019.95 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $144.54 Median $169.82 Typical High $281.84 | Professional | None | $144.54 | $169.82 | $281.84 |
Ambetter Setting Professional Modifier None Typical Low $117.49 Median $117.49 Typical High $117.49 | Professional | None | $117.49 | $117.49 | $117.49 |
AvMed Setting Facility Modifier None Typical Low $269.15 Median $1,445.44 Typical High $9,549.93 | Facility | None | $269.15 | $1,445.44 | $9,549.93 |
AvMed Setting Professional Modifier None Typical Low $177.83 Median $204.17 Typical High $257.04 | Professional | None | $177.83 | $204.17 | $257.04 |
Cigna Setting Facility Modifier None Typical Low $323.59 Median $1,659.59 Typical High $3,090.30 | Facility | None | $323.59 | $1,659.59 | $3,090.30 |
Cigna Setting Professional Modifier None Typical Low $141.25 Median $199.53 Typical High $380.19 | Professional | None | $141.25 | $199.53 | $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 $138.04 Median $181.97 Typical High $229.09 | Professional | None | $138.04 | $181.97 | $229.09 |
Molina Setting Professional Modifier None Typical Low $144.54 Median $213.80 Typical High $426.58 | Professional | None | $144.54 | $213.80 | $426.58 |
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 $138.04 Median $223.87 Typical High $426.58 | Professional | None | $138.04 | $223.87 | $426.58 |
Wellpoint Setting Professional Modifier None Typical Low $128.82 Median $186.21 Typical High $186.21 | Professional | None | $128.82 | $186.21 | $186.21 |
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 $79.43 Typical High $109.65 | Professional | 52 · Reduced service | $70.79 | $79.43 | $109.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.84 Median $31.62 Typical High $43.65 | Professional | 53 · Discontinued | $28.84 | $31.62 | $43.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $107.15 Median $120.23 Typical High $165.96 | Professional | 54 · Surgery only | $107.15 | $120.23 | $165.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.38 Median $23.99 Typical High $33.11 | Professional | 55 · Aftercare only | $21.38 | $23.99 | $33.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $15.85 Typical High $21.88 | Professional | 56 · Pre-op care only | $14.45 | $15.85 | $21.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $100.00 Median $112.20 Typical High $154.88 | Professional | 78 · Unplanned return to OR | $100.00 | $112.20 | $154.88 |
Where Florida sits
The same service costs 4.4 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· 38th 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.