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 $134.90 Median $194.98 Typical High $257.04 | Professional | None | $134.90 | $194.98 | $257.04 |
AvMed Setting Facility Modifier None Typical Low $181.97 Median $2,137.96 Typical High $11,748.98 | Facility | None | $181.97 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $154.88 Median $213.80 Typical High $281.84 | Professional | None | $154.88 | $213.80 | $281.84 |
Cigna Setting Facility Modifier None Typical Low $181.97 Median $302.00 Typical High $1,659.59 | Facility | None | $181.97 | $302.00 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $114.82 Median $181.97 Typical High $309.03 | Professional | None | $114.82 | $181.97 | $309.03 |
Florida Blue Setting Facility Modifier None Typical Low $199.53 Median $436.52 Typical High $6,309.57 | Facility | None | $199.53 | $436.52 | $6,309.57 |
Florida Blue Setting Professional Modifier None Typical Low $97.72 Median $218.78 Typical High $281.84 | Professional | None | $97.72 | $218.78 | $281.84 |
Molina Setting Professional Modifier None Typical Low $27.54 Median $173.78 Typical High $295.12 | Professional | None | $27.54 | $173.78 | $295.12 |
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 $112.20 Median $181.97 Typical High $354.81 | Professional | None | $112.20 | $181.97 | $354.81 |
Wellpoint Setting Professional Modifier None Typical Low $114.82 Median $204.17 Typical High $204.17 | Professional | None | $114.82 | $204.17 | $204.17 |
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 $67.61 Median $97.72 Typical High $125.89 | Professional | 52 · Reduced service | $67.61 | $97.72 | $125.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.92 Median $38.90 Typical High $50.12 | Professional | 53 · Discontinued | $26.92 | $38.90 | $50.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $100.00 Median $144.54 Typical High $186.21 | Professional | 54 · Surgery only | $100.00 | $144.54 | $186.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $28.84 Typical High $38.02 | Professional | 55 · Aftercare only | $19.95 | $28.84 | $38.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.49 Median $19.50 Typical High $25.12 | Professional | 56 · Pre-op care only | $13.49 | $19.50 | $25.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $93.33 Median $134.90 Typical High $173.78 | Professional | 78 · Unplanned return to OR | $93.33 | $134.90 | $173.78 |
Where Florida sits
The same service costs 3.7 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· 48th of 51
$195
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.