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 $630.96 Median $3,801.89 Typical High $11,748.98 | Facility | None | $630.96 | $3,801.89 | $11,748.98 |
Aetna Setting Professional Modifier None Typical Low $549.54 Median $645.65 Typical High $912.01 | Professional | None | $549.54 | $645.65 | $912.01 |
AvMed Setting Facility Modifier None Typical Low $630.96 Median $1,905.46 Typical High $9,549.93 | Facility | None | $630.96 | $1,905.46 | $9,549.93 |
AvMed Setting Professional Modifier None Typical Low $602.56 Median $691.83 Typical High $870.96 | Professional | None | $602.56 | $691.83 | $870.96 |
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 $478.63 Median $575.44 Typical High $1,000.00 | Professional | None | $478.63 | $575.44 | $1,000.00 |
Florida Blue Setting Facility Modifier None Typical Low $870.96 Median $1,995.26 Typical High $8,511.38 | Facility | None | $870.96 | $1,995.26 | $8,511.38 |
Florida Blue Setting Professional Modifier None Typical Low $549.54 Median $616.60 Typical High $891.25 | Professional | None | $549.54 | $616.60 | $891.25 |
Molina Setting Professional Modifier None Typical Low $75.86 Median $588.84 Typical High $933.25 | Professional | None | $75.86 | $588.84 | $933.25 |
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 $436.52 Median $616.60 Typical High $1,122.02 | Professional | None | $436.52 | $616.60 | $1,122.02 |
Wellpoint Setting Professional Modifier None Typical Low $446.68 Median $616.60 Typical High $616.60 | Professional | None | $446.68 | $616.60 | $616.60 |
7 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 $269.15 Median $316.23 Typical High $346.74 | Professional | 52 · Reduced service | $269.15 | $316.23 | $346.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $125.89 Typical High $138.04 | Professional | 53 · Discontinued | $109.65 | $125.89 | $138.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $407.38 Median $478.63 Typical High $524.81 | Professional | 54 · Surgery only | $407.38 | $478.63 | $524.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $95.50 Typical High $104.71 | Professional | 55 · Aftercare only | $81.28 | $95.50 | $104.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $63.10 Typical High $69.18 | Professional | 56 · Pre-op care only | $54.95 | $63.10 | $69.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $380.19 Median $446.68 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $380.19 | $446.68 | $489.78 |
Ambetter Setting Professional Modifier 51 · Multiple procedures Typical Low $501.19 Median $501.19 Typical High $501.19 | Professional | 51 · Multiple procedures | $501.19 | $501.19 | $501.19 |
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· 47th of 51
$692
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.