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 $691.83 Median $3,801.89 Typical High $11,481.54 | Facility | None | $691.83 | $3,801.89 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $691.83 Median $812.83 Typical High $1,174.90 | Professional | None | $691.83 | $812.83 | $1,174.90 |
Ambetter Setting Professional Modifier None Typical Low $776.25 Median $912.01 Typical High $954.99 | Professional | None | $776.25 | $912.01 | $954.99 |
AvMed Setting Facility Modifier None Typical Low $741.31 Median $1,905.46 Typical High $9,549.93 | Facility | None | $741.31 | $1,905.46 | $9,549.93 |
AvMed Setting Professional Modifier None Typical Low $741.31 Median $870.96 Typical High $1,096.48 | Professional | None | $741.31 | $870.96 | $1,096.48 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $1,318.26 Typical High $2,691.53 | Facility | None | $501.19 | $1,318.26 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $602.56 Median $724.44 Typical High $1,258.93 | Professional | None | $602.56 | $724.44 | $1,258.93 |
Florida Blue Setting Facility Modifier None Typical Low $660.69 Median $1,659.59 Typical High $8,511.38 | Facility | None | $660.69 | $1,659.59 | $8,511.38 |
Florida Blue Setting Professional Modifier None Typical Low $691.83 Median $776.25 Typical High $1,122.02 | Professional | None | $691.83 | $776.25 | $1,122.02 |
Molina Setting Professional Modifier None Typical Low $112.20 Median $741.31 Typical High $1,174.90 | Professional | None | $112.20 | $741.31 | $1,174.90 |
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 $537.03 Median $776.25 Typical High $1,412.54 | Professional | None | $537.03 | $776.25 | $1,412.54 |
Wellpoint Setting Professional Modifier None Typical Low $562.34 Median $776.25 Typical High $776.25 | Professional | None | $562.34 | $776.25 | $776.25 |
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 $346.74 Median $398.11 Typical High $436.52 | Professional | 52 · Reduced service | $346.74 | $398.11 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $162.18 Typical High $173.78 | Professional | 53 · Discontinued | $138.04 | $162.18 | $173.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $602.56 Typical High $660.69 | Professional | 54 · Surgery only | $512.86 | $602.56 | $660.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $120.23 Typical High $131.83 | Professional | 55 · Aftercare only | $102.33 | $120.23 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $79.43 Typical High $87.10 | Professional | 56 · Pre-op care only | $69.18 | $79.43 | $87.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $562.34 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $478.63 | $562.34 | $616.60 |
Where Florida sits
The same service costs 4.5 times more in Alaska than in Texas. 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· 49th of 51
$851
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.