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 $114.82 Median $138.04 Typical High $181.97 | Professional | None | $114.82 | $138.04 | $181.97 |
AvMed Setting Facility Modifier None Typical Low $204.17 Median $1,288.25 Typical High $9,549.93 | Facility | None | $204.17 | $1,288.25 | $9,549.93 |
AvMed Setting Professional Modifier None Typical Low $144.54 Median $162.18 Typical High $194.98 | Professional | None | $144.54 | $162.18 | $194.98 |
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 $117.49 Median $165.96 Typical High $309.03 | Professional | None | $117.49 | $165.96 | $309.03 |
Florida Blue Setting Facility Modifier None Typical Low $380.19 Median $776.25 Typical High $6,309.57 | Facility | None | $380.19 | $776.25 | $6,309.57 |
Florida Blue Setting Professional Modifier None Typical Low $112.20 Median $138.04 Typical High $177.83 | Professional | None | $112.20 | $138.04 | $177.83 |
Molina Setting Professional Modifier None Typical Low $120.23 Median $181.97 Typical High $354.81 | Professional | None | $120.23 | $181.97 | $354.81 |
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 $173.78 Typical High $338.84 | Professional | None | $112.20 | $173.78 | $338.84 |
Wellpoint Setting Professional Modifier None Typical Low $112.20 Median $144.54 Typical High $144.54 | Professional | None | $112.20 | $144.54 | $144.54 |
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 $57.54 Median $67.61 Typical High $87.10 | Professional | 52 · Reduced service | $57.54 | $67.61 | $87.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $27.54 Typical High $35.48 | Professional | 53 · Discontinued | $23.44 | $27.54 | $35.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $87.10 Median $102.33 Typical High $131.83 | Professional | 54 · Surgery only | $87.10 | $102.33 | $131.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $20.42 Typical High $26.30 | Professional | 55 · Aftercare only | $17.38 | $20.42 | $26.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $13.80 Typical High $17.78 | Professional | 56 · Pre-op care only | $11.48 | $13.80 | $17.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $81.28 Median $95.50 Typical High $123.03 | Professional | 78 · Unplanned return to OR | $81.28 | $95.50 | $123.03 |
Where Florida sits
The same service costs 4.6 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· 36th of 51
$214
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.