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 $3,311.31 Typical High $10,964.78 | Facility | None | $478.63 | $3,311.31 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $186.21 Median $275.42 Typical High $398.11 | Professional | None | $186.21 | $275.42 | $398.11 |
AvMed Setting Facility Modifier None Typical Low $204.17 Median $954.99 Typical High $9,549.93 | Facility | None | $204.17 | $954.99 | $9,549.93 |
AvMed Setting Professional Modifier None Typical Low $213.80 Median $323.59 Typical High $426.58 | Professional | None | $213.80 | $323.59 | $426.58 |
Cigna Setting Facility Modifier None Typical Low $218.78 Median $398.11 Typical High $2,187.76 | Facility | None | $218.78 | $398.11 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $269.15 Typical High $426.58 | Professional | None | $165.96 | $269.15 | $426.58 |
Florida Blue Setting Facility Modifier None Typical Low $34.67 Median $75.86 Typical High $3,981.07 | Facility | None | $34.67 | $75.86 | $3,981.07 |
Florida Blue Setting Professional Modifier None Typical Low $263.03 Median $288.40 Typical High $436.52 | Professional | None | $263.03 | $288.40 | $436.52 |
Molina Setting Professional Modifier None Typical Low $34.67 Median $309.03 Typical High $489.78 | Professional | None | $34.67 | $309.03 | $489.78 |
United Setting Facility Modifier None Typical Low $81.28 Median $302.00 Typical High $2,754.23 | Facility | None | $81.28 | $302.00 | $2,754.23 |
United Setting Professional Modifier None Typical Low $147.91 Median $257.04 Typical High $457.09 | Professional | None | $147.91 | $257.04 | $457.09 |
Wellpoint Setting Professional Modifier None Typical Low $154.88 Median $302.00 Typical High $302.00 | Professional | None | $154.88 | $302.00 | $302.00 |
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 $93.33 Median $138.04 Typical High $154.88 | Professional | 52 · Reduced service | $93.33 | $138.04 | $154.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $54.95 Typical High $61.66 | Professional | 53 · Discontinued | $37.15 | $54.95 | $61.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $141.25 Median $204.17 Typical High $229.09 | Professional | 54 · Surgery only | $141.25 | $204.17 | $229.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $41.69 Typical High $46.77 | Professional | 55 · Aftercare only | $28.18 | $41.69 | $46.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $27.54 Typical High $30.90 | Professional | 56 · Pre-op care only | $18.62 | $27.54 | $30.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $131.83 Median $190.55 Typical High $213.80 | Professional | 78 · Unplanned return to OR | $131.83 | $190.55 | $213.80 |
Where Florida sits
The same service costs 3.5 times more in Alaska than in Maryland. 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· 50th of 51
$275
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.