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 $162.18 Median $3,019.95 Typical High $10,964.78 | Facility | None | $162.18 | $3,019.95 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $112.20 Median $117.49 Typical High $177.83 | Professional | None | $112.20 | $117.49 | $177.83 |
Ambetter Setting Professional Modifier None Typical Low $263.03 Median $263.03 Typical High $263.03 | Professional | None | $263.03 | $263.03 | $263.03 |
AvMed Setting Facility Modifier None Typical Low $128.82 Median $2,137.96 Typical High $11,748.98 | Facility | None | $128.82 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $114.82 Median $134.90 Typical High $165.96 | Professional | None | $114.82 | $134.90 | $165.96 |
Cigna Setting Facility Modifier None Typical Low $91.20 Median $186.21 Typical High $1,659.59 | Facility | None | $91.20 | $186.21 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $102.33 Median $114.82 Typical High $223.87 | Professional | None | $102.33 | $114.82 | $223.87 |
Florida Blue Setting Facility Modifier None Typical Low $60.26 Median $134.90 Typical High $7,413.10 | Facility | None | $60.26 | $134.90 | $7,413.10 |
Florida Blue Setting Professional Modifier None Typical Low $64.57 Median $117.49 Typical High $204.17 | Professional | None | $64.57 | $117.49 | $204.17 |
Molina Setting Professional Modifier None Typical Low $81.28 Median $134.90 Typical High $223.87 | Professional | None | $81.28 | $134.90 | $223.87 |
United Setting Facility Modifier None Typical Low $794.33 Median $1,778.28 Typical High $7,585.78 | Facility | None | $794.33 | $1,778.28 | $7,585.78 |
United Setting Professional Modifier None Typical Low $97.72 Median $128.82 Typical High $234.42 | Professional | None | $97.72 | $128.82 | $234.42 |
Wellpoint Setting Professional Modifier None Typical Low $102.33 Median $144.54 Typical High $144.54 | Professional | None | $102.33 | $144.54 | $144.54 |
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 $54.95 Median $58.88 Typical High $83.18 | Professional | 52 · Reduced service | $54.95 | $58.88 | $83.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.39 Median $23.44 Typical High $33.11 | Professional | 53 · Discontinued | $22.39 | $23.44 | $33.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $83.18 Median $87.10 Typical High $125.89 | Professional | 54 · Surgery only | $83.18 | $87.10 | $125.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $17.78 Typical High $25.12 | Professional | 55 · Aftercare only | $16.60 | $17.78 | $25.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $11.75 Typical High $16.60 | Professional | 56 · Pre-op care only | $11.22 | $11.75 | $16.60 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $77.62 Median $81.28 Typical High $117.49 | Professional | 78 · Unplanned return to OR | $77.62 | $81.28 | $117.49 |
Where Florida sits
The same service costs 4.6 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
$132
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.