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 $107.15 Median $120.23 Typical High $154.88 | Professional | None | $107.15 | $120.23 | $154.88 |
AvMed Setting Facility Modifier None Typical Low $147.91 Median $1,000.00 Typical High $9,549.93 | Facility | None | $147.91 | $1,000.00 | $9,549.93 |
AvMed Setting Professional Modifier None Typical Low $123.03 Median $141.25 Typical High $165.96 | Professional | None | $123.03 | $141.25 | $165.96 |
Cigna Setting Facility Modifier None Typical Low $151.36 Median $302.00 Typical High $1,659.59 | Facility | None | $151.36 | $302.00 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $87.10 Median $109.65 Typical High $208.93 | Professional | None | $87.10 | $109.65 | $208.93 |
Florida Blue Setting Facility Modifier None Typical Low $616.60 Median $1,318.26 Typical High $3,019.95 | Facility | None | $616.60 | $1,318.26 | $3,019.95 |
Florida Blue Setting Professional Modifier None Typical Low $60.26 Median $138.04 Typical High $169.82 | Professional | None | $60.26 | $138.04 | $169.82 |
Molina Setting Professional Modifier None Typical Low $104.71 Median $138.04 Typical High $234.42 | Professional | None | $104.71 | $138.04 | $234.42 |
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 $91.20 Median $123.03 Typical High $234.42 | Professional | None | $91.20 | $123.03 | $234.42 |
Wellpoint Setting Professional Modifier None Typical Low $93.33 Median $120.23 Typical High $120.23 | Professional | None | $93.33 | $120.23 | $120.23 |
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 $53.70 Median $60.26 Typical High $77.62 | Professional | 52 · Reduced service | $53.70 | $60.26 | $77.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $23.99 Typical High $30.90 | Professional | 53 · Discontinued | $21.38 | $23.99 | $30.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $81.28 Median $89.13 Typical High $114.82 | Professional | 54 · Surgery only | $81.28 | $89.13 | $114.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $17.78 Typical High $22.91 | Professional | 55 · Aftercare only | $16.22 | $17.78 | $22.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $12.02 Typical High $15.49 | Professional | 56 · Pre-op care only | $10.72 | $12.02 | $15.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $75.86 Median $83.18 Typical High $107.15 | Professional | 78 · Unplanned return to OR | $75.86 | $83.18 | $107.15 |
Where Florida sits
The same service costs 3.8 times more in Alaska than in Delaware. 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· 50th of 51
$135
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.