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 $251.19 Median $3,019.95 Typical High $10,964.78 | Facility | None | $251.19 | $3,019.95 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $141.25 Median $199.53 Typical High $275.42 | Professional | None | $141.25 | $199.53 | $275.42 |
AvMed Setting Facility Modifier None Typical Low $181.97 Median $2,137.96 Typical High $11,748.98 | Facility | None | $181.97 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $151.36 Median $204.17 Typical High $281.84 | Professional | None | $151.36 | $204.17 | $281.84 |
Cigna Setting Facility Modifier None Typical Low $181.97 Median $363.08 Typical High $2,187.76 | Facility | None | $181.97 | $363.08 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $114.82 Median $177.83 Typical High $302.00 | Professional | None | $114.82 | $177.83 | $302.00 |
Florida Blue Setting Facility Modifier None Typical Low $199.53 Median $436.52 Typical High $16,982.44 | Facility | None | $199.53 | $436.52 | $16,982.44 |
Florida Blue Setting Professional Modifier None Typical Low $114.82 Median $186.21 Typical High $295.12 | Professional | None | $114.82 | $186.21 | $295.12 |
Molina Setting Professional Modifier None Typical Low $26.92 Median $169.82 Typical High $416.87 | Professional | None | $26.92 | $169.82 | $416.87 |
United Setting Facility Modifier None Typical Low $398.11 Median $1,000.00 Typical High $5,623.41 | Facility | None | $398.11 | $1,000.00 | $5,623.41 |
United Setting Professional Modifier None Typical Low $125.89 Median $190.55 Typical High $316.23 | Professional | None | $125.89 | $190.55 | $316.23 |
Wellpoint Setting Professional Modifier None Typical Low $117.49 Median $204.17 Typical High $204.17 | Professional | None | $117.49 | $204.17 | $204.17 |
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 $70.79 Median $100.00 Typical High $125.89 | Professional | 52 · Reduced service | $70.79 | $100.00 | $125.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $39.81 Typical High $51.29 | Professional | 53 · Discontinued | $28.18 | $39.81 | $51.29 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $107.15 Median $151.36 Typical High $190.55 | Professional | 54 · Surgery only | $107.15 | $151.36 | $190.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.38 Median $30.20 Typical High $38.02 | Professional | 55 · Aftercare only | $21.38 | $30.20 | $38.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $19.95 Typical High $25.70 | Professional | 56 · Pre-op care only | $14.13 | $19.95 | $25.70 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $100.00 Median $141.25 Typical High $177.83 | Professional | 78 · Unplanned return to OR | $100.00 | $141.25 | $177.83 |
Where Florida sits
The same service costs 3.6 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· 50th of 51
$186
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.