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 $602.56 Median $5,495.41 Typical High $12,022.64 | Facility | None | $602.56 | $5,495.41 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $239.88 Median $338.84 Typical High $489.78 | Professional | None | $239.88 | $338.84 | $489.78 |
AvMed Setting Facility Modifier None Typical Low $426.58 Median $2,137.96 Typical High $9,549.93 | Facility | None | $426.58 | $2,137.96 | $9,549.93 |
AvMed Setting Professional Modifier None Typical Low $275.42 Median $338.84 Typical High $457.09 | Professional | None | $275.42 | $338.84 | $457.09 |
Cigna Setting Facility Modifier None Typical Low $616.60 Median $1,905.46 Typical High $3,311.31 | Facility | None | $616.60 | $1,905.46 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $194.98 Median $288.40 Typical High $549.54 | Professional | None | $194.98 | $288.40 | $549.54 |
Florida Blue Setting Facility Modifier None Typical Low $870.96 Median $1,737.80 Typical High $16,982.44 | Facility | None | $870.96 | $1,737.80 | $16,982.44 |
Florida Blue Setting Professional Modifier None Typical Low $169.82 Median $371.54 Typical High $588.84 | Professional | None | $169.82 | $371.54 | $588.84 |
Molina Setting Professional Modifier None Typical Low $31.62 Median $234.42 Typical High $446.68 | Professional | None | $31.62 | $234.42 | $446.68 |
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 $199.53 Median $309.03 Typical High $616.60 | Professional | None | $199.53 | $309.03 | $616.60 |
Wellpoint Setting Professional Modifier None Typical Low $204.17 Median $316.23 Typical High $316.23 | Professional | None | $204.17 | $316.23 | $316.23 |
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 $169.82 Typical High $245.47 | Professional | 52 · Reduced service | $120.23 | $169.82 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $67.61 Typical High $97.72 | Professional | 53 · Discontinued | $48.98 | $67.61 | $97.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $181.97 Median $257.04 Typical High $363.08 | Professional | 54 · Surgery only | $181.97 | $257.04 | $363.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $51.29 Typical High $72.44 | Professional | 55 · Aftercare only | $36.31 | $51.29 | $72.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $33.88 Typical High $48.98 | Professional | 56 · Pre-op care only | $23.99 | $33.88 | $48.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $169.82 Median $239.88 Typical High $338.84 | Professional | 78 · Unplanned return to OR | $169.82 | $239.88 | $338.84 |
Where Florida sits
The same service costs 5.9 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
$316
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.