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 $707.95 Median $4,786.30 Typical High $11,748.98 | Facility | None | $707.95 | $4,786.30 | $11,748.98 |
Aetna Setting Professional Modifier None Typical Low $691.83 Median $794.33 Typical High $870.96 | Professional | None | $691.83 | $794.33 | $870.96 |
AvMed Setting Facility Modifier None Typical Low $676.08 Median $2,089.30 Typical High $9,772.37 | Facility | None | $676.08 | $2,089.30 | $9,772.37 |
AvMed Setting Professional Modifier None Typical Low $676.08 Median $851.14 Typical High $1,023.29 | Professional | None | $676.08 | $851.14 | $1,023.29 |
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 $660.69 Median $758.58 Typical High $1,258.93 | Professional | None | $660.69 | $758.58 | $1,258.93 |
Florida Blue Setting Facility Modifier None Typical Low $645.65 Median $1,348.96 Typical High $7,413.10 | Facility | None | $645.65 | $1,348.96 | $7,413.10 |
Florida Blue Setting Professional Modifier None Typical Low $602.56 Median $676.08 Typical High $977.24 | Professional | None | $602.56 | $676.08 | $977.24 |
Molina Setting Professional Modifier None Typical Low $72.44 Median $645.65 Typical High $1,000.00 | Professional | None | $72.44 | $645.65 | $1,000.00 |
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 $501.19 Median $776.25 Typical High $1,412.54 | Professional | None | $501.19 | $776.25 | $1,412.54 |
Wellpoint Setting Professional Modifier None Typical Low $645.65 Median $645.65 Typical High $851.14 | Professional | None | $645.65 | $645.65 | $851.14 |
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 $416.87 | Professional | 52 · Reduced service | $346.74 | $398.11 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $158.49 Typical High $165.96 | Professional | 53 · Discontinued | $138.04 | $158.49 | $165.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $588.84 Typical High $616.60 | Professional | 54 · Surgery only | $524.81 | $588.84 | $616.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $117.49 Typical High $123.03 | Professional | 55 · Aftercare only | $104.71 | $117.49 | $123.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $79.43 Typical High $83.18 | Professional | 56 · Pre-op care only | $69.18 | $79.43 | $83.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $549.54 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $489.78 | $549.54 | $575.44 |
Where Florida sits
The same service costs 7.6 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· 48th 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.