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 $3,090.30 Typical High $10,964.78 | Facility | None | $354.81 | $3,090.30 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $251.19 Median $316.23 Typical High $467.74 | Professional | None | $251.19 | $316.23 | $467.74 |
AvMed Setting Facility Modifier None Typical Low $323.59 Median $2,137.96 Typical High $11,748.98 | Facility | None | $323.59 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $302.00 Median $346.74 Typical High $457.09 | Professional | None | $302.00 | $346.74 | $457.09 |
Cigna Setting Facility Modifier None Typical Low $288.40 Median $457.09 Typical High $2,691.53 | Facility | None | $288.40 | $457.09 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $234.42 Median $316.23 Typical High $537.03 | Professional | None | $234.42 | $316.23 | $537.03 |
Florida Blue Setting Facility Modifier None Typical Low $199.53 Median $436.52 Typical High $7,413.10 | Facility | None | $199.53 | $436.52 | $7,413.10 |
Florida Blue Setting Professional Modifier None Typical Low $158.49 Median $302.00 Typical High $501.19 | Professional | None | $158.49 | $302.00 | $501.19 |
Molina Setting Professional Modifier None Typical Low $33.88 Median $263.03 Typical High $512.86 | Professional | None | $33.88 | $263.03 | $512.86 |
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 $223.87 Median $316.23 Typical High $562.34 | Professional | None | $223.87 | $316.23 | $562.34 |
Wellpoint Setting Professional Modifier None Typical Low $234.42 Median $398.11 Typical High $398.11 | Professional | None | $234.42 | $398.11 | $398.11 |
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 $125.89 Median $158.49 Typical High $204.17 | Professional | 52 · Reduced service | $125.89 | $158.49 | $204.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $50.12 Median $64.57 Typical High $81.28 | Professional | 53 · Discontinued | $50.12 | $64.57 | $81.28 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $190.55 Median $239.88 Typical High $309.03 | Professional | 54 · Surgery only | $190.55 | $239.88 | $309.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.02 Median $47.86 Typical High $61.66 | Professional | 55 · Aftercare only | $38.02 | $47.86 | $61.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.12 Median $31.62 Typical High $40.74 | Professional | 56 · Pre-op care only | $25.12 | $31.62 | $40.74 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $177.83 Median $223.87 Typical High $288.40 | Professional | 78 · Unplanned return to OR | $177.83 | $223.87 | $288.40 |
Where Florida sits
The same service costs 5.0 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
$339
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.