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 $416.87 Median $3,019.95 Typical High $10,964.78 | Facility | None | $416.87 | $3,019.95 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $363.08 Median $426.58 Typical High $562.34 | Professional | None | $363.08 | $426.58 | $562.34 |
AvMed Setting Facility Modifier None Typical Low $131.83 Median $954.99 Typical High $9,549.93 | Facility | None | $131.83 | $954.99 | $9,549.93 |
AvMed Setting Professional Modifier None Typical Low $446.68 Median $512.86 Typical High $602.56 | Professional | None | $446.68 | $512.86 | $602.56 |
Cigna Setting Facility Modifier None Typical Low $131.83 Median $281.84 Typical High $1,659.59 | Facility | None | $131.83 | $281.84 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $354.81 Median $398.11 Typical High $741.31 | Professional | None | $354.81 | $398.11 | $741.31 |
Florida Blue Setting Facility Modifier None Typical Low $64.57 Median $131.83 Typical High $3,019.95 | Facility | None | $64.57 | $131.83 | $3,019.95 |
Florida Blue Setting Professional Modifier None Typical Low $194.98 Median $457.09 Typical High $616.60 | Professional | None | $194.98 | $457.09 | $616.60 |
Molina Setting Professional Modifier None Typical Low $61.66 Median $371.54 Typical High $660.69 | Professional | None | $61.66 | $371.54 | $660.69 |
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 $323.59 Median $426.58 Typical High $831.76 | Professional | None | $323.59 | $426.58 | $831.76 |
Wellpoint Setting Professional Modifier None Typical Low $371.54 Median $446.68 Typical High $446.68 | Professional | None | $371.54 | $446.68 | $446.68 |
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 $181.97 Median $208.93 Typical High $269.15 | Professional | 52 · Reduced service | $181.97 | $208.93 | $269.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $72.44 Median $85.11 Typical High $107.15 | Professional | 53 · Discontinued | $72.44 | $85.11 | $107.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $275.42 Median $316.23 Typical High $407.38 | Professional | 54 · Surgery only | $275.42 | $316.23 | $407.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $63.10 Typical High $81.28 | Professional | 55 · Aftercare only | $54.95 | $63.10 | $81.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $42.66 Typical High $53.70 | Professional | 56 · Pre-op care only | $36.31 | $42.66 | $53.70 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $257.04 Median $295.12 Typical High $380.19 | Professional | 78 · Unplanned return to OR | $257.04 | $295.12 | $380.19 |
Where Florida sits
The same service costs 5.8 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
$398
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.