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 $3,801.89 Typical High $10,964.78 | Facility | None | $478.63 | $3,801.89 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $177.83 Median $281.84 Typical High $363.08 | Professional | None | $177.83 | $281.84 | $363.08 |
AvMed Setting Facility Modifier None Typical Low $239.88 Median $2,137.96 Typical High $11,748.98 | Facility | None | $239.88 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $199.53 Median $295.12 Typical High $389.05 | Professional | None | $199.53 | $295.12 | $389.05 |
Cigna Setting Facility Modifier None Typical Low $239.88 Median $478.63 Typical High $3,801.89 | Facility | None | $239.88 | $478.63 | $3,801.89 |
Cigna Setting Professional Modifier None Typical Low $162.18 Median $257.04 Typical High $436.52 | Professional | None | $162.18 | $257.04 | $436.52 |
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 $154.88 Median $275.42 Typical High $426.58 | Professional | None | $154.88 | $275.42 | $426.58 |
Molina Setting Professional Modifier None Typical Low $31.62 Median $288.40 Typical High $501.19 | Professional | None | $31.62 | $288.40 | $501.19 |
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 $165.96 Median $263.03 Typical High $478.63 | Professional | None | $165.96 | $263.03 | $478.63 |
Wellpoint Setting Professional Modifier None Typical Low $162.18 Median $338.84 Typical High $338.84 | Professional | None | $162.18 | $338.84 | $338.84 |
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 $89.13 Median $141.25 Typical High $162.18 | Professional | 52 · Reduced service | $89.13 | $141.25 | $162.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $56.23 Typical High $64.57 | Professional | 53 · Discontinued | $35.48 | $56.23 | $64.57 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $131.83 Median $208.93 Typical High $239.88 | Professional | 54 · Surgery only | $131.83 | $208.93 | $239.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $41.69 Typical High $47.86 | Professional | 55 · Aftercare only | $26.92 | $41.69 | $47.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $28.18 Typical High $32.36 | Professional | 56 · Pre-op care only | $17.78 | $28.18 | $32.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $123.03 Median $194.98 Typical High $223.87 | Professional | 78 · Unplanned return to OR | $123.03 | $194.98 | $223.87 |
Where Florida sits
The same service costs 3.9 times more in Wyoming 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· 50th of 51
$295
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.