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 $87.10 Median $109.65 Typical High $169.82 | Professional | None | $87.10 | $109.65 | $169.82 |
Ambetter Setting Professional Modifier None Typical Low $81.28 Median $138.04 Typical High $275.42 | Professional | None | $81.28 | $138.04 | $275.42 |
AvMed Setting Facility Modifier None Typical Low $109.65 Median $2,137.96 Typical High $11,748.98 | Facility | None | $109.65 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $97.72 Median $117.49 Typical High $147.91 | Professional | None | $97.72 | $117.49 | $147.91 |
Cigna Setting Facility Modifier None Typical Low $52.48 Median $104.71 Typical High $204.17 | Facility | None | $52.48 | $104.71 | $204.17 |
Cigna Setting Professional Modifier None Typical Low $79.43 Median $104.71 Typical High $190.55 | Professional | None | $79.43 | $104.71 | $190.55 |
Florida Blue Setting Facility Modifier None Typical Low $60.26 Median $131.83 Typical High $3,019.95 | Facility | None | $60.26 | $131.83 | $3,019.95 |
Florida Blue Setting Professional Modifier None Typical Low $60.26 Median $104.71 Typical High $177.83 | Professional | None | $60.26 | $104.71 | $177.83 |
Molina Setting Professional Modifier None Typical Low $81.28 Median $114.82 Typical High $190.55 | Professional | None | $81.28 | $114.82 | $190.55 |
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 $79.43 Median $112.20 Typical High $204.17 | Professional | None | $79.43 | $112.20 | $204.17 |
Wellpoint Setting Professional Modifier None Typical Low $81.28 Median $134.90 Typical High $134.90 | Professional | None | $81.28 | $134.90 | $134.90 |
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 $43.65 Median $54.95 Typical High $70.79 | Professional | 52 · Reduced service | $43.65 | $54.95 | $70.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.38 Median $22.39 Typical High $28.84 | Professional | 53 · Discontinued | $17.38 | $22.39 | $28.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $64.57 Median $83.18 Typical High $107.15 | Professional | 54 · Surgery only | $64.57 | $83.18 | $107.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.18 Median $16.60 Typical High $21.38 | Professional | 55 · Aftercare only | $13.18 | $16.60 | $21.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.71 Median $10.96 Typical High $14.13 | Professional | 56 · Pre-op care only | $8.71 | $10.96 | $14.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $60.26 Median $77.62 Typical High $100.00 | Professional | 78 · Unplanned return to OR | $60.26 | $77.62 | $100.00 |
Where Florida sits
The same service costs 4.1 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
$115
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.