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 $177.83 Median $245.47 Typical High $363.08 | Professional | None | $177.83 | $245.47 | $363.08 |
AvMed Setting Facility Modifier None Typical Low $281.84 Median $1,000.00 Typical High $9,549.93 | Facility | None | $281.84 | $1,000.00 | $9,549.93 |
AvMed Setting Professional Modifier None Typical Low $204.17 Median $263.03 Typical High $346.74 | Professional | None | $204.17 | $263.03 | $346.74 |
Cigna Setting Facility Modifier None Typical Low $288.40 Median $363.08 Typical High $1,659.59 | Facility | None | $288.40 | $363.08 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $147.91 Median $251.19 Typical High $501.19 | Professional | None | $147.91 | $251.19 | $501.19 |
Florida Blue Setting Facility Modifier None Typical Low $363.08 Median $776.25 Typical High $3,981.07 | Facility | None | $363.08 | $776.25 | $3,981.07 |
Florida Blue Setting Professional Modifier None Typical Low $208.93 Median $213.80 Typical High $302.00 | Professional | None | $208.93 | $213.80 | $302.00 |
Molina Setting Professional Modifier None Typical Low $34.67 Median $263.03 Typical High $537.03 | Professional | None | $34.67 | $263.03 | $537.03 |
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 $173.78 Median $316.23 Typical High $602.56 | Professional | None | $173.78 | $316.23 | $602.56 |
Wellpoint Setting Professional Modifier None Typical Low $151.36 Median $245.47 Typical High $245.47 | Professional | None | $151.36 | $245.47 | $245.47 |
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 $89.13 Median $123.03 Typical High $165.96 | Professional | 52 · Reduced service | $89.13 | $123.03 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $48.98 Typical High $67.61 | Professional | 53 · Discontinued | $35.48 | $48.98 | $67.61 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $131.83 Median $186.21 Typical High $251.19 | Professional | 54 · Surgery only | $131.83 | $186.21 | $251.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $37.15 Typical High $50.12 | Professional | 55 · Aftercare only | $26.92 | $37.15 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $24.55 Typical High $33.11 | Professional | 56 · Pre-op care only | $17.78 | $24.55 | $33.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $123.03 Median $173.78 Typical High $234.42 | Professional | 78 · Unplanned return to OR | $123.03 | $173.78 | $234.42 |
Where Florida sits
The same service costs 3.7 times more in Wisconsin 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· 42nd of 51
$309
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.