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 $407.38 Median $3,311.31 Typical High $11,481.54 | Facility | None | $407.38 | $3,311.31 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $239.88 Median $239.88 Typical High $323.59 | Professional | None | $239.88 | $239.88 | $323.59 |
AvMed Setting Facility Modifier None Typical Low $263.03 Median $2,137.96 Typical High $11,748.98 | Facility | None | $263.03 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $223.87 Median $275.42 Typical High $331.13 | Professional | None | $223.87 | $275.42 | $331.13 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $2,041.74 Typical High $3,388.44 | Facility | None | $489.78 | $2,041.74 | $3,388.44 |
Cigna Setting Professional Modifier None Typical Low $208.93 Median $281.84 Typical High $549.54 | Professional | None | $208.93 | $281.84 | $549.54 |
Florida Blue Setting Facility Modifier None Typical Low $891.25 Median $1,737.80 Typical High $16,982.44 | Facility | None | $891.25 | $1,737.80 | $16,982.44 |
Florida Blue Setting Professional Modifier None Typical Low $186.21 Median $199.53 Typical High $288.40 | Professional | None | $186.21 | $199.53 | $288.40 |
Molina Setting Professional Modifier None Typical Low $204.17 Median $288.40 Typical High $537.03 | Professional | None | $204.17 | $288.40 | $537.03 |
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 $60.26 Median $316.23 Typical High $602.56 | Professional | None | $60.26 | $316.23 | $602.56 |
Wellpoint Setting Professional Modifier None Typical Low $257.04 Median $257.04 Typical High $263.03 | Professional | None | $257.04 | $257.04 | $263.03 |
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 $117.49 Median $120.23 Typical High $154.88 | Professional | 52 · Reduced service | $117.49 | $120.23 | $154.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $47.86 Median $47.86 Typical High $61.66 | Professional | 53 · Discontinued | $47.86 | $47.86 | $61.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $177.83 Median $181.97 Typical High $234.42 | Professional | 54 · Surgery only | $177.83 | $181.97 | $234.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $36.31 Typical High $46.77 | Professional | 55 · Aftercare only | $35.48 | $36.31 | $46.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $23.99 Typical High $30.90 | Professional | 56 · Pre-op care only | $23.99 | $23.99 | $30.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $165.96 Median $169.82 Typical High $218.78 | Professional | 78 · Unplanned return to OR | $165.96 | $169.82 | $218.78 |
Where Florida sits
The same service costs 6.0 times more in Oklahoma 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· 21st of 51
$479
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.