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 $478.63 Median $3,801.89 Typical High $10,964.78 | Facility | None | $478.63 | $3,801.89 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $97.72 Median $109.65 Typical High $162.18 | Professional | None | $97.72 | $109.65 | $162.18 |
AvMed Setting Facility Modifier None Typical Low $120.23 Median $2,137.96 Typical High $11,748.98 | Facility | None | $120.23 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $112.20 Median $138.04 Typical High $173.78 | Professional | None | $112.20 | $138.04 | $173.78 |
Cigna Setting Facility Modifier None Typical Low $89.13 Median $177.83 Typical High $2,691.53 | Facility | None | $89.13 | $177.83 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $85.11 Median $134.90 Typical High $257.04 | Professional | None | $85.11 | $134.90 | $257.04 |
Florida Blue Setting Facility Modifier None Typical Low $60.26 Median $128.82 Typical High $16,982.44 | Facility | None | $60.26 | $128.82 | $16,982.44 |
Florida Blue Setting Professional Modifier None Typical Low $97.72 Median $123.03 Typical High $177.83 | Professional | None | $97.72 | $123.03 | $177.83 |
Molina Setting Professional Modifier None Typical Low $91.20 Median $144.54 Typical High $288.40 | Professional | None | $91.20 | $144.54 | $288.40 |
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 $91.20 Median $147.91 Typical High $281.84 | Professional | None | $91.20 | $147.91 | $281.84 |
Wellpoint Setting Professional Modifier None Typical Low $79.43 Median $125.89 Typical High $125.89 | Professional | None | $79.43 | $125.89 | $125.89 |
7 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 $48.98 Median $54.95 Typical High $74.13 | Professional | 52 · Reduced service | $48.98 | $54.95 | $74.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.50 Median $21.88 Typical High $29.51 | Professional | 53 · Discontinued | $19.50 | $21.88 | $29.51 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $72.44 Median $81.28 Typical High $112.20 | Professional | 54 · Surgery only | $72.44 | $81.28 | $112.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.45 Median $16.60 Typical High $22.39 | Professional | 55 · Aftercare only | $14.45 | $16.60 | $22.39 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.77 Median $10.96 Typical High $14.79 | Professional | 56 · Pre-op care only | $9.77 | $10.96 | $14.79 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $67.61 Median $75.86 Typical High $104.71 | Professional | 78 · Unplanned return to OR | $67.61 | $75.86 | $104.71 |
Ambetter Setting Professional Modifier 53 · Discontinued Typical Low $309.03 Median $309.03 Typical High $309.03 | Professional | 53 · Discontinued | $309.03 | $309.03 | $309.03 |
Where Florida sits
The same service costs 3.6 times more in Wisconsin 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· 48th of 51
$141
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.