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 $478.63 Median $3,090.30 Typical High $10,964.78 | Facility | None | $478.63 | $3,090.30 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $117.49 Median $213.80 Typical High $323.59 | Professional | None | $117.49 | $213.80 | $323.59 |
Ambetter Setting Professional Modifier None Typical Low $134.90 Median $263.03 Typical High $302.00 | Professional | None | $134.90 | $263.03 | $302.00 |
AvMed Setting Facility Modifier None Typical Low $199.53 Median $2,137.96 Typical High $11,748.98 | Facility | None | $199.53 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $134.90 Median $218.78 Typical High $288.40 | Professional | None | $134.90 | $218.78 | $288.40 |
Cigna Setting Facility Modifier None Typical Low $199.53 Median $316.23 Typical High $1,659.59 | Facility | None | $199.53 | $316.23 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $109.65 Median $190.55 Typical High $323.59 | Professional | None | $109.65 | $190.55 | $323.59 |
Florida Blue Setting Facility Modifier None Typical Low $199.53 Median $436.52 Typical High $5,370.32 | Facility | None | $199.53 | $436.52 | $5,370.32 |
Florida Blue Setting Professional Modifier None Typical Low $112.20 Median $204.17 Typical High $316.23 | Professional | None | $112.20 | $204.17 | $316.23 |
Molina Setting Professional Modifier None Typical Low $28.18 Median $199.53 Typical High $363.08 | Professional | None | $28.18 | $199.53 | $363.08 |
United Setting Facility Modifier None Typical Low $398.11 Median $1,000.00 Typical High $5,623.41 | Facility | None | $398.11 | $1,000.00 | $5,623.41 |
United Setting Professional Modifier None Typical Low $107.15 Median $194.98 Typical High $338.84 | Professional | None | $107.15 | $194.98 | $338.84 |
Wellpoint Setting Professional Modifier None Typical Low $107.15 Median $257.04 Typical High $257.04 | Professional | None | $107.15 | $257.04 | $257.04 |
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 $58.88 Median $107.15 Typical High $120.23 | Professional | 52 · Reduced service | $58.88 | $107.15 | $120.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $42.66 Typical High $47.86 | Professional | 53 · Discontinued | $23.44 | $42.66 | $47.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $87.10 Median $158.49 Typical High $181.97 | Professional | 54 · Surgery only | $87.10 | $158.49 | $181.97 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $32.36 Typical High $36.31 | Professional | 55 · Aftercare only | $17.38 | $32.36 | $36.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $21.38 Typical High $23.99 | Professional | 56 · Pre-op care only | $11.75 | $21.38 | $23.99 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $81.28 Median $147.91 Typical High $169.82 | Professional | 78 · Unplanned return to OR | $81.28 | $147.91 | $169.82 |
Where Florida sits
The same service costs 3.8 times more in Wyoming than in Kentucky. 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· 46th of 51
$224
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.