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 $660.69 Median $5,495.41 Typical High $14,454.40 | Facility | None | $660.69 | $5,495.41 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $165.96 Median $239.88 Typical High $316.23 | Professional | None | $165.96 | $239.88 | $316.23 |
AvMed Setting Facility Modifier None Typical Low $398.11 Median $2,691.53 Typical High $9,549.93 | Facility | None | $398.11 | $2,691.53 | $9,549.93 |
AvMed Setting Professional Modifier None Typical Low $199.53 Median $288.40 Typical High $380.19 | Professional | None | $199.53 | $288.40 | $380.19 |
Cigna Setting Facility Modifier None Typical Low $933.25 Median $1,737.80 Typical High $5,248.07 | Facility | None | $933.25 | $1,737.80 | $5,248.07 |
Cigna Setting Professional Modifier None Typical Low $154.88 Median $263.03 Typical High $389.05 | Professional | None | $154.88 | $263.03 | $389.05 |
Florida Blue Setting Facility Modifier None Typical Low $977.24 Median $2,089.30 Typical High $16,982.44 | Facility | None | $977.24 | $2,089.30 | $16,982.44 |
Florida Blue Setting Professional Modifier None Typical Low $134.90 Median $239.88 Typical High $416.87 | Professional | None | $134.90 | $239.88 | $416.87 |
Molina Setting Professional Modifier None Typical Low $26.92 Median $251.19 Typical High $616.60 | Professional | None | $26.92 | $251.19 | $616.60 |
United Setting Facility Modifier None Typical Low $794.33 Median $1,778.28 Typical High $7,585.78 | Facility | None | $794.33 | $1,778.28 | $7,585.78 |
United Setting Professional Modifier None Typical Low $151.36 Median $234.42 Typical High $398.11 | Professional | None | $151.36 | $234.42 | $398.11 |
Wellpoint Setting Professional Modifier None Typical Low $154.88 Median $288.40 Typical High $288.40 | Professional | None | $154.88 | $288.40 | $288.40 |
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 $83.18 Median $120.23 Typical High $154.88 | Professional | 52 · Reduced service | $83.18 | $120.23 | $154.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.11 Median $47.86 Typical High $61.66 | Professional | 53 · Discontinued | $33.11 | $47.86 | $61.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $125.89 Median $177.83 Typical High $234.42 | Professional | 54 · Surgery only | $125.89 | $177.83 | $234.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.12 Median $35.48 Typical High $46.77 | Professional | 55 · Aftercare only | $25.12 | $35.48 | $46.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $23.99 Typical High $30.90 | Professional | 56 · Pre-op care only | $16.60 | $23.99 | $30.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $117.49 Median $165.96 Typical High $218.78 | Professional | 78 · Unplanned return to OR | $117.49 | $165.96 | $218.78 |
Where Florida sits
The same service costs 3.7 times more in Wyoming 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
$257
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.