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 $354.81 Median $3,090.30 Typical High $10,964.78 | Facility | None | $354.81 | $3,090.30 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $218.78 Median $295.12 Typical High $371.54 | Professional | None | $218.78 | $295.12 | $371.54 |
AvMed Setting Facility Modifier None Typical Low $269.15 Median $2,137.96 Typical High $11,748.98 | Facility | None | $269.15 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $257.04 Median $316.23 Typical High $416.87 | Professional | None | $257.04 | $316.23 | $416.87 |
Cigna Setting Facility Modifier None Typical Low $257.04 Median $457.09 Typical High $2,691.53 | Facility | None | $257.04 | $457.09 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $181.97 Median $263.03 Typical High $489.78 | Professional | None | $181.97 | $263.03 | $489.78 |
Florida Blue Setting Facility Modifier None Typical Low $275.42 Median $588.84 Typical High $16,982.44 | Facility | None | $275.42 | $588.84 | $16,982.44 |
Florida Blue Setting Professional Modifier None Typical Low $147.91 Median $281.84 Typical High $407.38 | Professional | None | $147.91 | $281.84 | $407.38 |
Molina Setting Professional Modifier None Typical Low $31.62 Median $213.80 Typical High $416.87 | Professional | None | $31.62 | $213.80 | $416.87 |
United Setting Facility Modifier None Typical Low $794.33 Median $1,778.28 Typical High $7,585.78 | Facility | None | $794.33 | $1,778.28 | $7,585.78 |
United Setting Professional Modifier None Typical Low $190.55 Median $281.84 Typical High $562.34 | Professional | None | $190.55 | $281.84 | $562.34 |
Wellpoint Setting Professional Modifier None Typical Low $190.55 Median $295.12 Typical High $295.12 | Professional | None | $190.55 | $295.12 | $295.12 |
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 $109.65 Median $147.91 Typical High $181.97 | Professional | 52 · Reduced service | $109.65 | $147.91 | $181.97 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $44.67 Median $58.88 Typical High $74.13 | Professional | 53 · Discontinued | $44.67 | $58.88 | $74.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $165.96 Median $218.78 Typical High $275.42 | Professional | 54 · Surgery only | $165.96 | $218.78 | $275.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.11 Median $43.65 Typical High $54.95 | Professional | 55 · Aftercare only | $33.11 | $43.65 | $54.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $29.51 Typical High $36.31 | Professional | 56 · Pre-op care only | $21.88 | $29.51 | $36.31 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $154.88 Median $204.17 Typical High $257.04 | Professional | 78 · Unplanned return to OR | $154.88 | $204.17 | $257.04 |
Where Florida sits
The same service costs 5.2 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
$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.