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 $549.54 Median $3,715.35 Typical High $11,481.54 | Facility | None | $549.54 | $3,715.35 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $281.84 Median $295.12 Typical High $457.09 | Professional | None | $281.84 | $295.12 | $457.09 |
AvMed Setting Facility Modifier None Typical Low $275.42 Median $2,137.96 Typical High $11,748.98 | Facility | None | $275.42 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $245.47 Median $323.59 Typical High $346.74 | Professional | None | $245.47 | $323.59 | $346.74 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $501.19 Typical High $2,691.53 | Facility | None | $398.11 | $501.19 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $263.03 Median $275.42 Typical High $575.44 | Professional | None | $263.03 | $275.42 | $575.44 |
Florida Blue Setting Facility Modifier None Typical Low $10,471.29 Median $22,387.21 Typical High $33,884.42 | Facility | None | $10,471.29 | $22,387.21 | $33,884.42 |
Florida Blue Setting Professional Modifier None Typical Low $151.36 Median $245.47 Typical High $371.54 | Professional | None | $151.36 | $245.47 | $371.54 |
Molina Setting Professional Modifier None Typical Low $45.71 Median $199.53 Typical High $389.05 | Professional | None | $45.71 | $199.53 | $389.05 |
United Setting Facility Modifier None Typical Low $371.54 Median $954.99 Typical High $7,585.78 | Facility | None | $371.54 | $954.99 | $7,585.78 |
United Setting Professional Modifier None Typical Low $223.87 Median $316.23 Typical High $562.34 | Professional | None | $223.87 | $316.23 | $562.34 |
Wellpoint Setting Professional Modifier None Typical Low $257.04 Median $354.81 Typical High $354.81 | Professional | None | $257.04 | $354.81 | $354.81 |
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 $141.25 Median $147.91 Typical High $204.17 | Professional | 52 · Reduced service | $141.25 | $147.91 | $204.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $58.88 Typical High $81.28 | Professional | 53 · Discontinued | $56.23 | $58.88 | $81.28 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $213.80 Median $223.87 Typical High $309.03 | Professional | 54 · Surgery only | $213.80 | $223.87 | $309.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $42.66 Median $44.67 Typical High $61.66 | Professional | 55 · Aftercare only | $42.66 | $44.67 | $61.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $29.51 Typical High $40.74 | Professional | 56 · Pre-op care only | $28.18 | $29.51 | $40.74 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $199.53 Median $208.93 Typical High $288.40 | Professional | 78 · Unplanned return to OR | $199.53 | $208.93 | $288.40 |
Where Florida sits
The same service costs 6.9 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· 48th of 51
$324
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.