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 $630.96 Median $4,786.30 Typical High $11,748.98 | Facility | None | $630.96 | $4,786.30 | $11,748.98 |
Aetna Setting Professional Modifier None Typical Low $257.04 Median $263.03 Typical High $380.19 | Professional | None | $257.04 | $263.03 | $380.19 |
Ambetter Setting Professional Modifier None Typical Low $416.87 Median $416.87 Typical High $416.87 | Professional | None | $416.87 | $416.87 | $416.87 |
AvMed Setting Facility Modifier None Typical Low $501.19 Median $2,089.30 Typical High $9,772.37 | Facility | None | $501.19 | $2,089.30 | $9,772.37 |
AvMed Setting Professional Modifier None Typical Low $257.04 Median $323.59 Typical High $363.08 | Professional | None | $257.04 | $323.59 | $363.08 |
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 $239.88 Median $323.59 Typical High $616.60 | Professional | None | $239.88 | $323.59 | $616.60 |
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 $213.80 Median $229.09 Typical High $316.23 | Professional | None | $213.80 | $229.09 | $316.23 |
Molina Setting Professional Modifier None Typical Low $53.70 Median $257.04 Typical High $537.03 | Professional | None | $53.70 | $257.04 | $537.03 |
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 $60.26 Median $354.81 Typical High $676.08 | Professional | None | $60.26 | $354.81 | $676.08 |
Wellpoint Setting Professional Modifier None Typical Low $234.42 Median $234.42 Typical High $309.03 | Professional | None | $234.42 | $234.42 | $309.03 |
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 $128.82 Median $131.83 Typical High $177.83 | Professional | 52 · Reduced service | $128.82 | $131.83 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $51.29 Median $52.48 Typical High $70.79 | Professional | 53 · Discontinued | $51.29 | $52.48 | $70.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $190.55 Median $199.53 Typical High $263.03 | Professional | 54 · Surgery only | $190.55 | $199.53 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.02 Median $39.81 Typical High $52.48 | Professional | 55 · Aftercare only | $38.02 | $39.81 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $26.30 Typical High $35.48 | Professional | 56 · Pre-op care only | $25.70 | $26.30 | $35.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $177.83 Median $186.21 Typical High $245.47 | Professional | 78 · Unplanned return to OR | $177.83 | $186.21 | $245.47 |
Where Florida sits
The same service costs 11.2 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· 44th of 51
$363
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.