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 $120.23 Median $181.97 Typical High $218.78 | Professional | None | $120.23 | $181.97 | $218.78 |
AvMed Setting Facility Modifier None Typical Low $162.18 Median $2,137.96 Typical High $11,748.98 | Facility | None | $162.18 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $128.82 Median $181.97 Typical High $251.19 | Professional | None | $128.82 | $181.97 | $251.19 |
Cigna Setting Facility Modifier None Typical Low $162.18 Median $302.00 Typical High $1,659.59 | Facility | None | $162.18 | $302.00 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $102.33 Median $162.18 Typical High $269.15 | Professional | None | $102.33 | $162.18 | $269.15 |
Florida Blue Setting Facility Modifier None Typical Low $199.53 Median $426.58 Typical High $16,982.44 | Facility | None | $199.53 | $426.58 | $16,982.44 |
Florida Blue Setting Professional Modifier None Typical Low $102.33 Median $181.97 Typical High $263.03 | Professional | None | $102.33 | $181.97 | $263.03 |
Molina Setting Professional Modifier None Typical Low $128.82 Median $181.97 Typical High $426.58 | Professional | None | $128.82 | $181.97 | $426.58 |
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 $107.15 Median $169.82 Typical High $281.84 | Professional | None | $107.15 | $169.82 | $281.84 |
Wellpoint Setting Professional Modifier None Typical Low $100.00 Median $181.97 Typical High $181.97 | Professional | None | $100.00 | $181.97 | $181.97 |
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 $60.26 Median $91.20 Typical High $107.15 | Professional | 52 · Reduced service | $60.26 | $91.20 | $107.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.99 Median $36.31 Typical High $42.66 | Professional | 53 · Discontinued | $23.99 | $36.31 | $42.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $91.20 Median $134.90 Typical High $162.18 | Professional | 54 · Surgery only | $91.20 | $134.90 | $162.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $26.92 Typical High $32.36 | Professional | 55 · Aftercare only | $18.20 | $26.92 | $32.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $18.20 Typical High $21.38 | Professional | 56 · Pre-op care only | $12.02 | $18.20 | $21.38 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $85.11 Median $125.89 Typical High $151.36 | Professional | 78 · Unplanned return to OR | $85.11 | $125.89 | $151.36 |
Where Florida sits
The same service costs 3.5 times more in Alaska than in New Jersey. 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· 48th of 51
$174
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.