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 $3,019.95 Typical High $10,964.78 | Facility | None | $354.81 | $3,019.95 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $169.82 Median $204.17 Typical High $275.42 | Professional | None | $169.82 | $204.17 | $275.42 |
AvMed Setting Facility Modifier None Typical Low $218.78 Median $1,288.25 Typical High $9,549.93 | Facility | None | $218.78 | $1,288.25 | $9,549.93 |
AvMed Setting Professional Modifier None Typical Low $204.17 Median $245.47 Typical High $288.40 | Professional | None | $204.17 | $245.47 | $288.40 |
Cigna Setting Facility Modifier None Typical Low $323.59 Median $1,023.29 Typical High $1,659.59 | Facility | None | $323.59 | $1,023.29 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $173.78 Median $186.21 Typical High $346.74 | Professional | None | $173.78 | $186.21 | $346.74 |
Florida Blue Setting Facility Modifier None Typical Low $213.80 Median $467.74 Typical High $6,309.57 | Facility | None | $213.80 | $467.74 | $6,309.57 |
Florida Blue Setting Professional Modifier None Typical Low $87.10 Median $199.53 Typical High $295.12 | Professional | None | $87.10 | $199.53 | $295.12 |
Molina Setting Professional Modifier None Typical Low $27.54 Median $181.97 Typical High $302.00 | Professional | None | $27.54 | $181.97 | $302.00 |
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 $154.88 Median $194.98 Typical High $389.05 | Professional | None | $154.88 | $194.98 | $389.05 |
Wellpoint Setting Professional Modifier None Typical Low $245.47 Median $269.15 Typical High $269.15 | Professional | None | $245.47 | $269.15 | $269.15 |
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 $85.11 Median $100.00 Typical High $128.82 | Professional | 52 · Reduced service | $85.11 | $100.00 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $40.74 Typical High $51.29 | Professional | 53 · Discontinued | $33.88 | $40.74 | $51.29 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $151.36 Typical High $190.55 | Professional | 54 · Surgery only | $128.82 | $151.36 | $190.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $30.20 Typical High $38.90 | Professional | 55 · Aftercare only | $25.70 | $30.20 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $20.42 Typical High $25.70 | Professional | 56 · Pre-op care only | $16.98 | $20.42 | $25.70 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $120.23 Median $141.25 Typical High $177.83 | Professional | 78 · Unplanned return to OR | $120.23 | $141.25 | $177.83 |
Where Florida sits
The same service costs 5.4 times more in Alaska than in Utah. 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
$209
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.