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 $72.44 Median $181.97 Typical High $229.09 | Professional | None | $72.44 | $181.97 | $229.09 |
AvMed Setting Facility Modifier None Typical Low $190.55 Median $2,137.96 Typical High $11,748.98 | Facility | None | $190.55 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $85.11 Median $186.21 Typical High $245.47 | Professional | None | $85.11 | $186.21 | $245.47 |
Cigna Setting Facility Modifier None Typical Low $199.53 Median $316.23 Typical High $1,659.59 | Facility | None | $199.53 | $316.23 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $67.61 Median $165.96 Typical High $263.03 | Professional | None | $67.61 | $165.96 | $263.03 |
Florida Blue Setting Facility Modifier None Typical Low $199.53 Median $436.52 Typical High $5,370.32 | Facility | None | $199.53 | $436.52 | $5,370.32 |
Florida Blue Setting Professional Modifier None Typical Low $89.13 Median $169.82 Typical High $269.15 | Professional | None | $89.13 | $169.82 | $269.15 |
Molina Setting Professional Modifier None Typical Low $27.54 Median $173.78 Typical High $316.23 | Professional | None | $27.54 | $173.78 | $316.23 |
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 $66.07 Median $147.91 Typical High $275.42 | Professional | None | $66.07 | $147.91 | $275.42 |
Wellpoint Setting Professional Modifier None Typical Low $67.61 Median $218.78 Typical High $218.78 | Professional | None | $67.61 | $218.78 | $218.78 |
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 $36.31 Median $91.20 Typical High $104.71 | Professional | 52 · Reduced service | $36.31 | $91.20 | $104.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.45 Median $37.15 Typical High $41.69 | Professional | 53 · Discontinued | $14.45 | $37.15 | $41.69 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $53.70 Median $138.04 Typical High $154.88 | Professional | 54 · Surgery only | $53.70 | $138.04 | $154.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.96 Median $27.54 Typical High $31.62 | Professional | 55 · Aftercare only | $10.96 | $27.54 | $31.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.24 Median $18.20 Typical High $20.89 | Professional | 56 · Pre-op care only | $7.24 | $18.20 | $20.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $50.12 Median $128.82 Typical High $144.54 | Professional | 78 · Unplanned return to OR | $50.12 | $128.82 | $144.54 |
Where Florida sits
The same service costs 5.6 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· 39th of 51
$195
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.