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 $3,090.30 Typical High $10,964.78 | Facility | None | $478.63 | $3,090.30 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $154.88 Median $181.97 Typical High $251.19 | Professional | None | $154.88 | $181.97 | $251.19 |
AvMed Setting Facility Modifier None Typical Low $288.40 Median $1,513.56 Typical High $9,549.93 | Facility | None | $288.40 | $1,513.56 | $9,549.93 |
AvMed Setting Professional Modifier None Typical Low $190.55 Median $223.87 Typical High $288.40 | Professional | None | $190.55 | $223.87 | $288.40 |
Cigna Setting Facility Modifier None Typical Low $426.58 Median $575.44 Typical High $2,187.76 | Facility | None | $426.58 | $575.44 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $138.04 Median $186.21 Typical High $323.59 | Professional | None | $138.04 | $186.21 | $323.59 |
Florida Blue Setting Facility Modifier None Typical Low $363.08 Median $776.25 Typical High $4,466.84 | Facility | None | $363.08 | $776.25 | $4,466.84 |
Florida Blue Setting Professional Modifier None Typical Low $91.20 Median $218.78 Typical High $295.12 | Professional | None | $91.20 | $218.78 | $295.12 |
Molina Setting Professional Modifier None Typical Low $158.49 Median $234.42 Typical High $398.11 | Professional | None | $158.49 | $234.42 | $398.11 |
United Setting Facility Modifier None Typical Low $281.84 Median $660.69 Typical High $4,073.80 | Facility | None | $281.84 | $660.69 | $4,073.80 |
United Setting Professional Modifier None Typical Low $128.82 Median $181.97 Typical High $371.54 | Professional | None | $128.82 | $181.97 | $371.54 |
Wellpoint Setting Professional Modifier None Typical Low $141.25 Median $213.80 Typical High $213.80 | Professional | None | $141.25 | $213.80 | $213.80 |
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 $77.62 Median $91.20 Typical High $123.03 | Professional | 52 · Reduced service | $77.62 | $91.20 | $123.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $36.31 Typical High $48.98 | Professional | 53 · Discontinued | $30.90 | $36.31 | $48.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $114.82 Median $138.04 Typical High $181.97 | Professional | 54 · Surgery only | $114.82 | $138.04 | $181.97 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $27.54 Typical High $36.31 | Professional | 55 · Aftercare only | $22.91 | $27.54 | $36.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $18.20 Typical High $24.55 | Professional | 56 · Pre-op care only | $15.49 | $18.20 | $24.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $107.15 Median $128.82 Typical High $169.82 | Professional | 78 · Unplanned return to OR | $107.15 | $128.82 | $169.82 |
Where Florida sits
The same service costs 4.3 times more in Alaska than in Kentucky. 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
$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.