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 $549.54 Median $3,715.35 Typical High $11,481.54 | Facility | None | $549.54 | $3,715.35 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $275.42 Median $288.40 Typical High $457.09 | Professional | None | $275.42 | $288.40 | $457.09 |
Ambetter Setting Professional Modifier None Typical Low $338.84 Median $467.74 Typical High $467.74 | Professional | None | $338.84 | $467.74 | $467.74 |
AvMed Setting Facility Modifier None Typical Low $281.84 Median $2,137.96 Typical High $11,748.98 | Facility | None | $281.84 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $263.03 Median $331.13 Typical High $389.05 | Professional | None | $263.03 | $331.13 | $389.05 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $512.86 Typical High $2,691.53 | Facility | None | $398.11 | $512.86 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $245.47 Median $338.84 Typical High $645.65 | Professional | None | $245.47 | $338.84 | $645.65 |
Florida Blue Setting Facility Modifier None Typical Low $776.25 Median $1,621.81 Typical High $25,703.96 | Facility | None | $776.25 | $1,621.81 | $25,703.96 |
Florida Blue Setting Professional Modifier None Typical Low $218.78 Median $234.42 Typical High $338.84 | Professional | None | $218.78 | $234.42 | $338.84 |
Molina Setting Professional Modifier None Typical Low $69.18 Median $295.12 Typical High $575.44 | Professional | None | $69.18 | $295.12 | $575.44 |
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 $60.26 Median $371.54 Typical High $691.83 | Professional | None | $60.26 | $371.54 | $691.83 |
Wellpoint Setting Professional Modifier None Typical Low $234.42 Median $234.42 Typical High $316.23 | Professional | None | $234.42 | $234.42 | $316.23 |
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 $138.04 Median $141.25 Typical High $177.83 | Professional | 52 · Reduced service | $138.04 | $141.25 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $56.23 Typical High $72.44 | Professional | 53 · Discontinued | $54.95 | $56.23 | $72.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $213.80 Typical High $269.15 | Professional | 54 · Surgery only | $208.93 | $213.80 | $269.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $42.66 Typical High $53.70 | Professional | 55 · Aftercare only | $41.69 | $42.66 | $53.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $28.18 Typical High $36.31 | Professional | 56 · Pre-op care only | $27.54 | $28.18 | $36.31 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $194.98 Median $199.53 Typical High $251.19 | Professional | 78 · Unplanned return to OR | $194.98 | $199.53 | $251.19 |
Where Florida sits
The same service costs 5.8 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· 42nd of 51
$389
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.