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 $131.83 Median $181.97 Typical High $263.03 | Professional | None | $131.83 | $181.97 | $263.03 |
AvMed Setting Facility Modifier None Typical Low $144.54 Median $2,137.96 Typical High $11,748.98 | Facility | None | $144.54 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $134.90 Median $190.55 Typical High $245.47 | Professional | None | $134.90 | $190.55 | $245.47 |
Cigna Setting Facility Modifier None Typical Low $144.54 Median $288.40 Typical High $1,659.59 | Facility | None | $144.54 | $288.40 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $112.20 Median $165.96 Typical High $269.15 | Professional | None | $112.20 | $165.96 | $269.15 |
Florida Blue Setting Facility Modifier None Typical Low $114.82 Median $251.19 Typical High $3,981.07 | Facility | None | $114.82 | $251.19 | $3,981.07 |
Florida Blue Setting Professional Modifier None Typical Low $158.49 Median $177.83 Typical High $257.04 | Professional | None | $158.49 | $177.83 | $257.04 |
Molina Setting Professional Modifier None Typical Low $128.82 Median $177.83 Typical High $269.15 | Professional | None | $128.82 | $177.83 | $269.15 |
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 $165.96 Typical High $295.12 | Professional | None | $102.33 | $165.96 | $295.12 |
Wellpoint Setting Professional Modifier None Typical Low $107.15 Median $177.83 Typical High $177.83 | Professional | None | $107.15 | $177.83 | $177.83 |
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 $66.07 Median $89.13 Typical High $100.00 | Professional | 52 · Reduced service | $66.07 | $89.13 | $100.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.30 Median $36.31 Typical High $39.81 | Professional | 53 · Discontinued | $26.30 | $36.31 | $39.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $97.72 Median $134.90 Typical High $147.91 | Professional | 54 · Surgery only | $97.72 | $134.90 | $147.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $26.92 Typical High $30.20 | Professional | 55 · Aftercare only | $19.50 | $26.92 | $30.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $18.20 Typical High $19.95 | Professional | 56 · Pre-op care only | $13.18 | $18.20 | $19.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $91.20 Median $125.89 Typical High $138.04 | Professional | 78 · Unplanned return to OR | $91.20 | $125.89 | $138.04 |
Where Florida sits
The same service costs 3.5 times more in Alaska 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· 50th of 51
$182
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.