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 $162.18 Median $181.97 Typical High $269.15 | Professional | None | $162.18 | $181.97 | $269.15 |
Ambetter Setting Professional Modifier None Typical Low $134.90 Median $269.15 Typical High $398.11 | Professional | None | $134.90 | $269.15 | $398.11 |
AvMed Setting Facility Modifier None Typical Low $204.17 Median $2,137.96 Typical High $11,748.98 | Facility | None | $204.17 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $181.97 Median $213.80 Typical High $269.15 | Professional | None | $181.97 | $213.80 | $269.15 |
Cigna Setting Facility Modifier None Typical Low $134.90 Median $269.15 Typical High $1,659.59 | Facility | None | $134.90 | $269.15 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $151.36 Median $177.83 Typical High $338.84 | Professional | None | $151.36 | $177.83 | $338.84 |
Florida Blue Setting Facility Modifier None Typical Low $114.82 Median $251.19 Typical High $3,019.95 | Facility | None | $114.82 | $251.19 | $3,019.95 |
Florida Blue Setting Professional Modifier None Typical Low $107.15 Median $190.55 Typical High $295.12 | Professional | None | $107.15 | $190.55 | $295.12 |
Molina Setting Professional Modifier None Typical Low $144.54 Median $234.42 Typical High $371.54 | Professional | None | $144.54 | $234.42 | $371.54 |
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 $147.91 Median $199.53 Typical High $354.81 | Professional | None | $147.91 | $199.53 | $354.81 |
Wellpoint Setting Professional Modifier None Typical Low $151.36 Median $229.09 Typical High $229.09 | Professional | None | $151.36 | $229.09 | $229.09 |
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 $81.28 Median $91.20 Typical High $123.03 | Professional | 52 · Reduced service | $81.28 | $91.20 | $123.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $37.15 Typical High $48.98 | Professional | 53 · Discontinued | $32.36 | $37.15 | $48.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $123.03 Median $138.04 Typical High $181.97 | Professional | 54 · Surgery only | $123.03 | $138.04 | $181.97 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $27.54 Typical High $37.15 | Professional | 55 · Aftercare only | $24.55 | $27.54 | $37.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $18.20 Typical High $24.55 | Professional | 56 · Pre-op care only | $16.22 | $18.20 | $24.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $114.82 Median $128.82 Typical High $169.82 | Professional | 78 · Unplanned return to OR | $114.82 | $128.82 | $169.82 |
Where Florida sits
The same service costs 4.3 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
$204
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.