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 $123.03 Median $162.18 Typical High $213.80 | Professional | None | $123.03 | $162.18 | $213.80 |
AvMed Setting Facility Modifier None Typical Low $234.42 Median $1,288.25 Typical High $9,549.93 | Facility | None | $234.42 | $1,288.25 | $9,549.93 |
AvMed Setting Professional Modifier None Typical Low $144.54 Median $177.83 Typical High $234.42 | Professional | None | $144.54 | $177.83 | $234.42 |
Cigna Setting Facility Modifier None Typical Low $323.59 Median $776.25 Typical High $1,659.59 | Facility | None | $323.59 | $776.25 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $112.20 Median $151.36 Typical High $251.19 | Professional | None | $112.20 | $151.36 | $251.19 |
Florida Blue Setting Facility Modifier None Typical Low $616.60 Median $1,348.96 Typical High $6,309.57 | Facility | None | $616.60 | $1,348.96 | $6,309.57 |
Florida Blue Setting Professional Modifier None Typical Low $91.20 Median $165.96 Typical High $245.47 | Professional | None | $91.20 | $165.96 | $245.47 |
Molina Setting Professional Modifier None Typical Low $128.82 Median $165.96 Typical High $398.11 | Professional | None | $128.82 | $165.96 | $398.11 |
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 $112.20 Median $158.49 Typical High $263.03 | Professional | None | $112.20 | $158.49 | $263.03 |
Wellpoint Setting Professional Modifier None Typical Low $109.65 Median $165.96 Typical High $165.96 | Professional | None | $109.65 | $165.96 | $165.96 |
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 $61.66 Median $81.28 Typical High $100.00 | Professional | 52 · Reduced service | $61.66 | $81.28 | $100.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $32.36 Typical High $39.81 | Professional | 53 · Discontinued | $24.55 | $32.36 | $39.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $91.20 Median $120.23 Typical High $151.36 | Professional | 54 · Surgery only | $91.20 | $120.23 | $151.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $23.99 Typical High $30.20 | Professional | 55 · Aftercare only | $18.62 | $23.99 | $30.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $16.22 Typical High $19.95 | Professional | 56 · Pre-op care only | $12.30 | $16.22 | $19.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $85.11 Median $112.20 Typical High $141.25 | Professional | 78 · Unplanned return to OR | $85.11 | $112.20 | $141.25 |
Where Florida sits
The same service costs 4.2 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· 50th of 51
$162
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.