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 $457.09 Median $3,090.30 Typical High $10,964.78 | Facility | None | $457.09 | $3,090.30 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $107.15 Median $165.96 Typical High $275.42 | Professional | None | $107.15 | $165.96 | $275.42 |
Ambetter Setting Professional Modifier None Typical Low $239.88 Median $239.88 Typical High $239.88 | Professional | None | $239.88 | $239.88 | $239.88 |
AvMed Setting Facility Modifier None Typical Low $162.18 Median $2,137.96 Typical High $11,748.98 | Facility | None | $162.18 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $131.83 Median $177.83 Typical High $234.42 | Professional | None | $131.83 | $177.83 | $234.42 |
Cigna Setting Facility Modifier None Typical Low $162.18 Median $323.59 Typical High $2,691.53 | Facility | None | $162.18 | $323.59 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $102.33 Median $169.82 Typical High $346.74 | Professional | None | $102.33 | $169.82 | $346.74 |
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 $128.82 Median $147.91 Typical High $204.17 | Professional | None | $128.82 | $147.91 | $204.17 |
Molina Setting Professional Modifier None Typical Low $134.90 Median $199.53 Typical High $398.11 | Professional | None | $134.90 | $199.53 | $398.11 |
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 $102.33 Median $190.55 Typical High $371.54 | Professional | None | $102.33 | $190.55 | $371.54 |
Wellpoint Setting Professional Modifier None Typical Low $97.72 Median $169.82 Typical High $169.82 | Professional | None | $97.72 | $169.82 | $169.82 |
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 $53.70 Median $83.18 Typical High $102.33 | Professional | 52 · Reduced service | $53.70 | $83.18 | $102.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $33.11 Typical High $40.74 | Professional | 53 · Discontinued | $21.88 | $33.11 | $40.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $81.28 Median $125.89 Typical High $154.88 | Professional | 54 · Surgery only | $81.28 | $125.89 | $154.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $25.12 Typical High $30.90 | Professional | 55 · Aftercare only | $16.22 | $25.12 | $30.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $16.60 Typical High $20.42 | Professional | 56 · Pre-op care only | $10.72 | $16.60 | $20.42 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $75.86 Median $117.49 Typical High $144.54 | Professional | 78 · Unplanned return to OR | $75.86 | $117.49 | $144.54 |
Where Florida sits
The same service costs 3.5 times more in Wisconsin 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· 43rd of 51
$209
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.