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 $112.20 Median $151.36 Typical High $229.09 | Professional | None | $112.20 | $151.36 | $229.09 |
AvMed Setting Facility Modifier None Typical Low $213.80 Median $2,137.96 Typical High $11,748.98 | Facility | None | $213.80 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $151.36 Median $213.80 Typical High $281.84 | Professional | None | $151.36 | $213.80 | $281.84 |
Cigna Setting Facility Modifier None Typical Low $52.48 Median $147.91 Typical High $295.12 | Facility | None | $52.48 | $147.91 | $295.12 |
Cigna Setting Professional Modifier None Typical Low $141.25 Median $177.83 Typical High $288.40 | Professional | None | $141.25 | $177.83 | $288.40 |
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 $63.10 Median $186.21 Typical High $288.40 | Professional | None | $63.10 | $186.21 | $288.40 |
Molina Setting Professional Modifier None Typical Low $29.51 Median $173.78 Typical High $316.23 | Professional | None | $29.51 | $173.78 | $316.23 |
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 $123.03 Median $165.96 Typical High $338.84 | Professional | None | $123.03 | $165.96 | $338.84 |
Wellpoint Setting Professional Modifier None Typical Low $147.91 Median $154.88 Typical High $154.88 | Professional | None | $147.91 | $154.88 | $154.88 |
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 $56.23 Median $75.86 Typical High $114.82 | Professional | 52 · Reduced service | $56.23 | $75.86 | $114.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.39 Median $30.90 Typical High $45.71 | Professional | 53 · Discontinued | $22.39 | $30.90 | $45.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $85.11 Median $114.82 Typical High $169.82 | Professional | 54 · Surgery only | $85.11 | $114.82 | $169.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $22.91 Typical High $33.88 | Professional | 55 · Aftercare only | $16.98 | $22.91 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $15.14 Typical High $22.91 | Professional | 56 · Pre-op care only | $11.22 | $15.14 | $22.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $79.43 Median $107.15 Typical High $158.49 | Professional | 78 · Unplanned return to OR | $79.43 | $107.15 | $158.49 |
Where Florida sits
The same service costs 5.0 times more in Alaska than in Florida. 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· 51st of 51
$166
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.