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 $776.25 Median $5,888.44 Typical High $12,022.64 | Facility | None | $776.25 | $5,888.44 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $194.98 Median $223.87 Typical High $281.84 | Professional | None | $194.98 | $223.87 | $281.84 |
AvMed Setting Facility Modifier None Typical Low $501.19 Median $2,137.96 Typical High $9,772.37 | Facility | None | $501.19 | $2,137.96 | $9,772.37 |
AvMed Setting Professional Modifier None Typical Low $181.97 Median $223.87 Typical High $263.03 | Professional | None | $181.97 | $223.87 | $263.03 |
Cigna Setting Facility Modifier None Typical Low $616.60 Median $1,737.80 Typical High $3,311.31 | Facility | None | $616.60 | $1,737.80 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $173.78 Median $186.21 Typical High $346.74 | Professional | None | $173.78 | $186.21 | $346.74 |
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 $112.20 Median $234.42 Typical High $269.15 | Professional | None | $112.20 | $234.42 | $269.15 |
Molina Setting Professional Modifier None Typical Low $131.83 Median $165.96 Typical High $407.38 | Professional | None | $131.83 | $165.96 | $407.38 |
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 $165.96 Median $213.80 Typical High $354.81 | Professional | None | $165.96 | $213.80 | $354.81 |
Wellpoint Setting Professional Modifier None Typical Low $173.78 Median $173.78 Typical High $173.78 | Professional | None | $173.78 | $173.78 | $173.78 |
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 $97.72 Median $112.20 Typical High $131.83 | Professional | 52 · Reduced service | $97.72 | $112.20 | $131.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $44.67 Typical High $52.48 | Professional | 53 · Discontinued | $38.90 | $44.67 | $52.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $147.91 Median $169.82 Typical High $194.98 | Professional | 54 · Surgery only | $147.91 | $169.82 | $194.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $29.51 Median $33.88 Typical High $38.90 | Professional | 55 · Aftercare only | $29.51 | $33.88 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $22.39 Typical High $26.30 | Professional | 56 · Pre-op care only | $19.50 | $22.39 | $26.30 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $138.04 Median $158.49 Typical High $181.97 | Professional | 78 · Unplanned return to OR | $138.04 | $158.49 | $181.97 |
Where Florida sits
The same service costs 6.0 times more in Alaska than in Utah. 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· 49th of 51
$204
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.