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 $3,981.07 Typical High $12,882.50 | Facility | None | $645.65 | $3,981.07 | $12,882.50 |
Aetna Setting Professional Modifier None Typical Low $371.54 Median $389.05 Typical High $645.65 | Professional | None | $371.54 | $389.05 | $645.65 |
Ambetter Setting Professional Modifier None Typical Low $501.19 Median $660.69 Typical High $1,000.00 | Professional | None | $501.19 | $660.69 | $1,000.00 |
AvMed Setting Facility Modifier None Typical Low $426.58 Median $2,137.96 Typical High $12,882.50 | Facility | None | $426.58 | $2,137.96 | $12,882.50 |
AvMed Setting Professional Modifier None Typical Low $371.54 Median $446.68 Typical High $588.84 | Professional | None | $371.54 | $446.68 | $588.84 |
Cigna Setting Facility Modifier None Typical Low $288.40 Median $407.38 Typical High $11,481.54 | Facility | None | $288.40 | $407.38 | $11,481.54 |
Cigna Setting Professional Modifier None Typical Low $338.84 Median $371.54 Typical High $758.58 | Professional | None | $338.84 | $371.54 | $758.58 |
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 $288.40 Median $398.11 Typical High $660.69 | Professional | None | $288.40 | $398.11 | $660.69 |
Molina Setting Professional Modifier None Typical Low $67.61 Median $323.59 Typical High $602.56 | Professional | None | $67.61 | $323.59 | $602.56 |
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 $338.84 Median $457.09 Typical High $812.83 | Professional | None | $338.84 | $457.09 | $812.83 |
Wellpoint Setting Professional Modifier None Typical Low $338.84 Median $478.63 Typical High $478.63 | Professional | None | $338.84 | $478.63 | $478.63 |
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 $186.21 Median $194.98 Typical High $281.84 | Professional | 52 · Reduced service | $186.21 | $194.98 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $74.13 Median $77.62 Typical High $114.82 | Professional | 53 · Discontinued | $74.13 | $77.62 | $114.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $275.42 Median $288.40 Typical High $426.58 | Professional | 54 · Surgery only | $275.42 | $288.40 | $426.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $57.54 Typical High $85.11 | Professional | 55 · Aftercare only | $54.95 | $57.54 | $85.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $38.90 Typical High $57.54 | Professional | 56 · Pre-op care only | $37.15 | $38.90 | $57.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $257.04 Median $269.15 Typical High $398.11 | Professional | 78 · Unplanned return to OR | $257.04 | $269.15 | $398.11 |
Where Florida sits
The same service costs 6.2 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· 50th 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.