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 $138.04 Median $208.93 Typical High $229.09 | Professional | None | $138.04 | $208.93 | $229.09 |
AvMed Setting Facility Modifier None Typical Low $194.98 Median $2,137.96 Typical High $11,748.98 | Facility | None | $194.98 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $186.21 Median $245.47 Typical High $316.23 | Professional | None | $186.21 | $245.47 | $316.23 |
Cigna Setting Facility Modifier None Typical Low $52.48 Median $204.17 Typical High $398.11 | Facility | None | $52.48 | $204.17 | $398.11 |
Cigna Setting Professional Modifier None Typical Low $138.04 Median $208.93 Typical High $331.13 | Professional | None | $138.04 | $208.93 | $331.13 |
Florida Blue Setting Facility Modifier None Typical Low $199.53 Median $436.52 Typical High $7,413.10 | Facility | None | $199.53 | $436.52 | $7,413.10 |
Florida Blue Setting Professional Modifier None Typical Low $204.17 Median $218.78 Typical High $323.59 | Professional | None | $204.17 | $218.78 | $323.59 |
Molina Setting Professional Modifier None Typical Low $34.67 Median $229.09 Typical High $363.08 | Professional | None | $34.67 | $229.09 | $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 $125.89 Median $208.93 Typical High $371.54 | Professional | None | $125.89 | $208.93 | $371.54 |
Wellpoint Setting Professional Modifier None Typical Low $134.90 Median $229.09 Typical High $229.09 | Professional | None | $134.90 | $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 $69.18 Median $104.71 Typical High $112.20 | Professional | 52 · Reduced service | $69.18 | $104.71 | $112.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $41.69 Typical High $44.67 | Professional | 53 · Discontinued | $28.18 | $41.69 | $44.67 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $104.71 Median $154.88 Typical High $169.82 | Professional | 54 · Surgery only | $104.71 | $154.88 | $169.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $31.62 Typical High $33.88 | Professional | 55 · Aftercare only | $20.89 | $31.62 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $20.89 Typical High $22.39 | Professional | 56 · Pre-op care only | $13.80 | $20.89 | $22.39 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $97.72 Median $144.54 Typical High $158.49 | Professional | 78 · Unplanned return to OR | $97.72 | $144.54 | $158.49 |
Where Florida sits
The same service costs 3.5 times more in Alaska than in Texas. 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· 49th of 51
$229
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.