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 $645.65 Median $3,890.45 Typical High $12,022.64 | Facility | None | $645.65 | $3,890.45 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $363.08 Median $380.19 Typical High $501.19 | Professional | None | $363.08 | $380.19 | $501.19 |
Ambetter Setting Professional Modifier None Typical Low $562.34 Median $562.34 Typical High $562.34 | Professional | None | $562.34 | $562.34 | $562.34 |
AvMed Setting Facility Modifier None Typical Low $389.05 Median $2,137.96 Typical High $11,748.98 | Facility | None | $389.05 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $354.81 Median $436.52 Typical High $524.81 | Professional | None | $354.81 | $436.52 | $524.81 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $501.19 Typical High $2,691.53 | Facility | None | $398.11 | $501.19 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $316.23 Median $436.52 Typical High $831.76 | Professional | None | $316.23 | $436.52 | $831.76 |
Florida Blue Setting Facility Modifier None Typical Low $10,471.29 Median $22,387.21 Typical High $33,884.42 | Facility | None | $10,471.29 | $22,387.21 | $33,884.42 |
Florida Blue Setting Professional Modifier None Typical Low $288.40 Median $309.03 Typical High $446.68 | Professional | None | $288.40 | $309.03 | $446.68 |
Molina Setting Professional Modifier None Typical Low $67.61 Median $316.23 Typical High $645.65 | Professional | None | $67.61 | $316.23 | $645.65 |
United Setting Facility Modifier None Typical Low $371.54 Median $954.99 Typical High $7,585.78 | Facility | None | $371.54 | $954.99 | $7,585.78 |
United Setting Professional Modifier None Typical Low $60.26 Median $478.63 Typical High $912.01 | Professional | None | $60.26 | $478.63 | $912.01 |
Wellpoint Setting Professional Modifier None Typical Low $302.00 Median $302.00 Typical High $416.87 | Professional | None | $302.00 | $302.00 | $416.87 |
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 $177.83 Median $190.55 Typical High $223.87 | Professional | 52 · Reduced service | $177.83 | $190.55 | $223.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $72.44 Median $75.86 Typical High $89.13 | Professional | 53 · Discontinued | $72.44 | $75.86 | $89.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $269.15 Median $281.84 Typical High $338.84 | Professional | 54 · Surgery only | $269.15 | $281.84 | $338.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $56.23 Typical High $67.61 | Professional | 55 · Aftercare only | $53.70 | $56.23 | $67.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $38.02 Typical High $44.67 | Professional | 56 · Pre-op care only | $35.48 | $38.02 | $44.67 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $251.19 Median $263.03 Typical High $316.23 | Professional | 78 · Unplanned return to OR | $251.19 | $263.03 | $316.23 |
Where Florida sits
The same service costs 5.0 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· 48th of 51
$407
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.