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 $3,019.95 Typical High $10,964.78 | Facility | None | $354.81 | $3,019.95 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $173.78 Median $223.87 Typical High $371.54 | Professional | None | $173.78 | $223.87 | $371.54 |
Ambetter Setting Professional Modifier None Typical Low $169.82 Median $281.84 Typical High $524.81 | Professional | None | $169.82 | $281.84 | $524.81 |
AvMed Setting Facility Modifier None Typical Low $245.47 Median $1,905.46 Typical High $9,772.37 | Facility | None | $245.47 | $1,905.46 | $9,772.37 |
AvMed Setting Professional Modifier None Typical Low $199.53 Median $245.47 Typical High $354.81 | Professional | None | $199.53 | $245.47 | $354.81 |
Cigna Setting Facility Modifier None Typical Low $190.55 Median $316.23 Typical High $1,659.59 | Facility | None | $190.55 | $316.23 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $162.18 Median $213.80 Typical High $389.05 | Professional | None | $162.18 | $213.80 | $389.05 |
Florida Blue Setting Facility Modifier None Typical Low $199.53 Median $436.52 Typical High $3,981.07 | Facility | None | $199.53 | $436.52 | $3,981.07 |
Florida Blue Setting Professional Modifier None Typical Low $186.21 Median $234.42 Typical High $398.11 | Professional | None | $186.21 | $234.42 | $398.11 |
Molina Setting Professional Modifier None Typical Low $31.62 Median $234.42 Typical High $407.38 | Professional | None | $31.62 | $234.42 | $407.38 |
United Setting Facility Modifier None Typical Low $281.84 Median $660.69 Typical High $4,073.80 | Facility | None | $281.84 | $660.69 | $4,073.80 |
United Setting Professional Modifier None Typical Low $169.82 Median $245.47 Typical High $457.09 | Professional | None | $169.82 | $245.47 | $457.09 |
Wellpoint Setting Professional Modifier None Typical Low $162.18 Median $275.42 Typical High $275.42 | Professional | None | $162.18 | $275.42 | $275.42 |
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 $87.10 Median $112.20 Typical High $147.91 | Professional | 52 · Reduced service | $87.10 | $112.20 | $147.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $44.67 Typical High $58.88 | Professional | 53 · Discontinued | $34.67 | $44.67 | $58.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $131.83 Median $165.96 Typical High $218.78 | Professional | 54 · Surgery only | $131.83 | $165.96 | $218.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $33.88 Typical High $43.65 | Professional | 55 · Aftercare only | $26.30 | $33.88 | $43.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $22.39 Typical High $29.51 | Professional | 56 · Pre-op care only | $17.38 | $22.39 | $29.51 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $123.03 Median $154.88 Typical High $204.17 | Professional | 78 · Unplanned return to OR | $123.03 | $154.88 | $204.17 |
Where Florida sits
The same service costs 4.2 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· 49th of 51
$257
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.