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 $537.03 Median $4,365.16 Typical High $11,748.98 | Facility | None | $537.03 | $4,365.16 | $11,748.98 |
Aetna Setting Professional Modifier None Typical Low $239.88 Median $263.03 Typical High $338.84 | Professional | None | $239.88 | $263.03 | $338.84 |
AvMed Setting Facility Modifier None Typical Low $331.13 Median $1,737.80 Typical High $9,549.93 | Facility | None | $331.13 | $1,737.80 | $9,549.93 |
AvMed Setting Professional Modifier None Typical Low $269.15 Median $309.03 Typical High $346.74 | Professional | None | $269.15 | $309.03 | $346.74 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $1,023.29 Typical High $2,691.53 | Facility | None | $501.19 | $1,023.29 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $194.98 Median $229.09 Typical High $457.09 | Professional | None | $194.98 | $229.09 | $457.09 |
Florida Blue Setting Facility Modifier None Typical Low $812.83 Median $1,819.70 Typical High $6,309.57 | Facility | None | $812.83 | $1,819.70 | $6,309.57 |
Florida Blue Setting Professional Modifier None Typical Low $128.82 Median $295.12 Typical High $446.68 | Professional | None | $128.82 | $295.12 | $446.68 |
Molina Setting Professional Modifier None Typical Low $31.62 Median $181.97 Typical High $338.84 | Professional | None | $31.62 | $181.97 | $338.84 |
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 $194.98 Median $263.03 Typical High $501.19 | Professional | None | $194.98 | $263.03 | $501.19 |
Wellpoint Setting Professional Modifier None Typical Low $204.17 Median $251.19 Typical High $251.19 | Professional | None | $204.17 | $251.19 | $251.19 |
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 $120.23 Median $128.82 Typical High $165.96 | Professional | 52 · Reduced service | $120.23 | $128.82 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $47.86 Median $51.29 Typical High $66.07 | Professional | 53 · Discontinued | $47.86 | $51.29 | $66.07 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $177.83 Median $190.55 Typical High $245.47 | Professional | 54 · Surgery only | $177.83 | $190.55 | $245.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $38.90 Typical High $48.98 | Professional | 55 · Aftercare only | $35.48 | $38.90 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $25.70 Typical High $33.11 | Professional | 56 · Pre-op care only | $23.99 | $25.70 | $33.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $165.96 Median $177.83 Typical High $229.09 | Professional | 78 · Unplanned return to OR | $165.96 | $177.83 | $229.09 |
Where Florida sits
The same service costs 6.8 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
$251
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.