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 $43.65 Median $3,311.31 Typical High $12,022.64 | Facility | None | $43.65 | $3,311.31 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $38.90 Median $42.66 Typical High $50.12 | Professional | None | $38.90 | $42.66 | $50.12 |
AvMed Setting Facility Modifier None Typical Low $45.71 Median $2,137.96 Typical High $11,748.98 | Facility | None | $45.71 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $42.66 Median $46.77 Typical High $57.54 | Professional | None | $42.66 | $46.77 | $57.54 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $66.07 Typical High $724.44 | Facility | None | $50.12 | $66.07 | $724.44 |
Cigna Setting Professional Modifier None Typical Low $36.31 Median $41.69 Typical High $66.07 | Professional | None | $36.31 | $41.69 | $66.07 |
Florida Blue Setting Facility Modifier None Typical Low $34.67 Median $70.79 Typical High $2,137.96 | Facility | None | $34.67 | $70.79 | $2,137.96 |
Florida Blue Setting Professional Modifier None Typical Low $37.15 Median $41.69 Typical High $67.61 | Professional | None | $37.15 | $41.69 | $67.61 |
Molina Setting Professional Modifier None Typical Low $36.31 Median $56.23 Typical High $85.11 | Professional | None | $36.31 | $56.23 | $85.11 |
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 $32.36 Median $43.65 Typical High $77.62 | Professional | None | $32.36 | $43.65 | $77.62 |
Wellpoint Setting Professional Modifier None Typical Low $33.88 Median $40.74 Typical High $40.74 | Professional | None | $33.88 | $40.74 | $40.74 |
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 $19.50 Median $21.38 Typical High $22.91 | Professional | 52 · Reduced service | $19.50 | $21.38 | $22.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.76 Median $8.51 Typical High $9.33 | Professional | 53 · Discontinued | $7.76 | $8.51 | $9.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $28.84 Median $31.62 Typical High $34.67 | Professional | 54 · Surgery only | $28.84 | $31.62 | $34.67 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.75 Median $6.31 Typical High $6.92 | Professional | 55 · Aftercare only | $5.75 | $6.31 | $6.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.89 Median $4.27 Typical High $4.68 | Professional | 56 · Pre-op care only | $3.89 | $4.27 | $4.68 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $26.92 Median $29.51 Typical High $32.36 | Professional | 78 · Unplanned return to OR | $26.92 | $29.51 | $32.36 |
Where Florida sits
The same service costs 4.6 times more in Alaska than in New York. 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· 47th of 51
$47.86
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.