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 $100.00 Median $169.82 Typical High $208.93 | Professional | None | $100.00 | $169.82 | $208.93 |
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 $112.20 Median $181.97 Typical High $239.88 | Professional | None | $112.20 | $181.97 | $239.88 |
Cigna Setting Facility Modifier None Typical Low $128.82 Median $269.15 Typical High $1,659.59 | Facility | None | $128.82 | $269.15 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $83.18 Median $165.96 Typical High $257.04 | Professional | None | $83.18 | $165.96 | $257.04 |
Florida Blue Setting Facility Modifier None Typical Low $114.82 Median $251.19 Typical High $3,019.95 | Facility | None | $114.82 | $251.19 | $3,019.95 |
Florida Blue Setting Professional Modifier None Typical Low $93.33 Median $147.91 Typical High $263.03 | Professional | None | $93.33 | $147.91 | $263.03 |
Molina Setting Professional Modifier None Typical Low $26.92 Median $141.25 Typical High $338.84 | Professional | None | $26.92 | $141.25 | $338.84 |
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 $85.11 Median $147.91 Typical High $251.19 | Professional | None | $85.11 | $147.91 | $251.19 |
Wellpoint Setting Professional Modifier None Typical Low $87.10 Median $177.83 Typical High $177.83 | Professional | None | $87.10 | $177.83 | $177.83 |
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 $50.12 Median $85.11 Typical High $104.71 | Professional | 52 · Reduced service | $50.12 | $85.11 | $104.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.95 Median $33.88 Typical High $41.69 | Professional | 53 · Discontinued | $19.95 | $33.88 | $41.69 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $74.13 Median $125.89 Typical High $154.88 | Professional | 54 · Surgery only | $74.13 | $125.89 | $154.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.79 Median $25.12 Typical High $30.90 | Professional | 55 · Aftercare only | $14.79 | $25.12 | $30.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.00 Median $16.98 Typical High $20.89 | Professional | 56 · Pre-op care only | $10.00 | $16.98 | $20.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $69.18 Median $117.49 Typical High $144.54 | Professional | 78 · Unplanned return to OR | $69.18 | $117.49 | $144.54 |
Where Florida sits
The same service costs 3.5 times more in Alaska 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· 46th of 51
$155
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.