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 $147.91 Median $2,884.03 Typical High $10,964.78 | Facility | None | $147.91 | $2,884.03 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $117.49 Median $131.83 Typical High $204.17 | Professional | None | $117.49 | $131.83 | $204.17 |
Ambetter Setting Professional Modifier None Typical Low $128.82 Median $151.36 Typical High $177.83 | Professional | None | $128.82 | $151.36 | $177.83 |
AvMed Setting Facility Modifier None Typical Low $141.25 Median $1,513.56 Typical High $9,772.37 | Facility | None | $141.25 | $1,513.56 | $9,772.37 |
AvMed Setting Professional Modifier None Typical Low $117.49 Median $144.54 Typical High $190.55 | Professional | None | $117.49 | $144.54 | $190.55 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $89.13 Typical High $537.03 | Facility | None | $66.07 | $89.13 | $537.03 |
Cigna Setting Professional Modifier None Typical Low $93.33 Median $123.03 Typical High $218.78 | Professional | None | $93.33 | $123.03 | $218.78 |
Florida Blue Setting Facility Modifier None Typical Low $34.67 Median $70.79 Typical High $3,019.95 | Facility | None | $34.67 | $70.79 | $3,019.95 |
Florida Blue Setting Professional Modifier None Typical Low $64.57 Median $144.54 Typical High $177.83 | Professional | None | $64.57 | $144.54 | $177.83 |
Molina Setting Professional Modifier None Typical Low $81.28 Median $141.25 Typical High $229.09 | Professional | None | $81.28 | $141.25 | $229.09 |
United Setting Facility Modifier None Typical Low $81.28 Median $302.00 Typical High $2,818.38 | Facility | None | $81.28 | $302.00 | $2,818.38 |
United Setting Professional Modifier None Typical Low $93.33 Median $125.89 Typical High $245.47 | Professional | None | $93.33 | $125.89 | $245.47 |
Wellpoint Setting Professional Modifier None Typical Low $85.11 Median $123.03 Typical High $123.03 | Professional | None | $85.11 | $123.03 | $123.03 |
7 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 $57.54 Median $64.57 Typical High $75.86 | Professional | 52 · Reduced service | $57.54 | $64.57 | $75.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $26.30 Typical High $30.90 | Professional | 53 · Discontinued | $22.91 | $26.30 | $30.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $87.10 Median $97.72 Typical High $114.82 | Professional | 54 · Surgery only | $87.10 | $97.72 | $114.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $19.50 Typical High $22.91 | Professional | 55 · Aftercare only | $17.38 | $19.50 | $22.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $12.88 Typical High $15.49 | Professional | 56 · Pre-op care only | $11.48 | $12.88 | $15.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $81.28 Median $91.20 Typical High $107.15 | Professional | 78 · Unplanned return to OR | $81.28 | $91.20 | $107.15 |
Ambetter Setting Professional Modifier SA · Nurse practitioner Typical Low $173.78 Median $173.78 Typical High $173.78 | Professional | SA · Nurse practitioner | $173.78 | $173.78 | $173.78 |
Where Florida sits
The same service costs 3.9 times more in Alaska than in Florida. 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· 51st of 51
$129
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.