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 $354.81 Median $4,786.30 Typical High $12,882.50 | Facility | None | $354.81 | $4,786.30 | $12,882.50 |
Aetna Setting Professional Modifier None Typical Low $309.03 Median $338.84 Typical High $467.74 | Professional | None | $309.03 | $338.84 | $467.74 |
Ambetter Setting Professional Modifier None Typical Low $489.78 Median $489.78 Typical High $489.78 | Professional | None | $489.78 | $489.78 | $489.78 |
AvMed Setting Facility Modifier None Typical Low $416.87 Median $2,137.96 Typical High $9,772.37 | Facility | None | $416.87 | $2,137.96 | $9,772.37 |
AvMed Setting Professional Modifier None Typical Low $363.08 Median $426.58 Typical High $501.19 | Professional | None | $363.08 | $426.58 | $501.19 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $2,041.74 Typical High $3,801.89 | Facility | None | $691.83 | $2,041.74 | $3,801.89 |
Cigna Setting Professional Modifier None Typical Low $302.00 Median $407.38 Typical High $741.31 | Professional | None | $302.00 | $407.38 | $741.31 |
Florida Blue Setting Facility Modifier None Typical Low $831.76 Median $1,288.25 Typical High $2,511.89 | Facility | None | $831.76 | $1,288.25 | $2,511.89 |
Florida Blue Setting Professional Modifier None Typical Low $295.12 Median $331.13 Typical High $446.68 | Professional | None | $295.12 | $331.13 | $446.68 |
Molina Setting Professional Modifier None Typical Low $67.61 Median $371.54 Typical High $776.25 | Professional | None | $67.61 | $371.54 | $776.25 |
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 $288.40 Median $436.52 Typical High $851.14 | Professional | None | $288.40 | $436.52 | $851.14 |
Wellpoint Setting Professional Modifier None Typical Low $263.03 Median $331.13 Typical High $331.13 | Professional | None | $263.03 | $331.13 | $331.13 |
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 $154.88 Median $165.96 Typical High $204.17 | Professional | 52 · Reduced service | $154.88 | $165.96 | $204.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $61.66 Median $66.07 Typical High $83.18 | Professional | 53 · Discontinued | $61.66 | $66.07 | $83.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $234.42 Median $251.19 Typical High $309.03 | Professional | 54 · Surgery only | $234.42 | $251.19 | $309.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $46.77 Median $50.12 Typical High $61.66 | Professional | 55 · Aftercare only | $46.77 | $50.12 | $61.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $33.11 Typical High $41.69 | Professional | 56 · Pre-op care only | $30.90 | $33.11 | $41.69 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $218.78 Median $234.42 Typical High $288.40 | Professional | 78 · Unplanned return to OR | $218.78 | $234.42 | $288.40 |
Where Florida sits
The same service costs 3.8 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
$447
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.