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 $102.33 Median $204.17 Typical High $257.04 | Professional | None | $102.33 | $204.17 | $257.04 |
AvMed Setting Facility Modifier None Typical Low $281.84 Median $1,318.26 Typical High $9,549.93 | Facility | None | $281.84 | $1,318.26 | $9,549.93 |
AvMed Setting Professional Modifier None Typical Low $120.23 Median $208.93 Typical High $275.42 | Professional | None | $120.23 | $208.93 | $275.42 |
Cigna Setting Facility Modifier None Typical Low $436.52 Median $645.65 Typical High $2,187.76 | Facility | None | $436.52 | $645.65 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $95.50 Median $186.21 Typical High $309.03 | Professional | None | $95.50 | $186.21 | $309.03 |
Florida Blue Setting Facility Modifier None Typical Low $363.08 Median $776.25 Typical High $5,370.32 | Facility | None | $363.08 | $776.25 | $5,370.32 |
Florida Blue Setting Professional Modifier None Typical Low $107.15 Median $194.98 Typical High $323.59 | Professional | None | $107.15 | $194.98 | $323.59 |
Molina Setting Professional Modifier None Typical Low $28.18 Median $186.21 Typical High $346.74 | Professional | None | $28.18 | $186.21 | $346.74 |
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 $93.33 Median $181.97 Typical High $316.23 | Professional | None | $93.33 | $181.97 | $316.23 |
Wellpoint Setting Professional Modifier None Typical Low $95.50 Median $245.47 Typical High $245.47 | Professional | None | $95.50 | $245.47 | $245.47 |
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 $51.29 Median $102.33 Typical High $117.49 | Professional | 52 · Reduced service | $51.29 | $102.33 | $117.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $41.69 Typical High $46.77 | Professional | 53 · Discontinued | $20.42 | $41.69 | $46.77 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $75.86 Median $154.88 Typical High $173.78 | Professional | 54 · Surgery only | $75.86 | $154.88 | $173.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $30.90 Typical High $34.67 | Professional | 55 · Aftercare only | $15.14 | $30.90 | $34.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $20.42 Typical High $23.44 | Professional | 56 · Pre-op care only | $10.23 | $20.42 | $23.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $70.79 Median $144.54 Typical High $162.18 | Professional | 78 · Unplanned return to OR | $70.79 | $144.54 | $162.18 |
Where Florida sits
The same service costs 4.7 times more in Alaska than in Virginia. 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· 38th of 51
$240
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.