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 $323.59 Median $389.05 Typical High $501.19 | Professional | None | $323.59 | $389.05 | $501.19 |
AvMed Setting Facility Modifier None Typical Low $446.68 Median $1,479.11 Typical High $9,772.37 | Facility | None | $446.68 | $1,479.11 | $9,772.37 |
AvMed Setting Professional Modifier None Typical Low $354.81 Median $416.87 Typical High $524.81 | Professional | None | $354.81 | $416.87 | $524.81 |
Cigna Setting Facility Modifier None Typical Low $436.52 Median $1,698.24 Typical High $2,754.23 | Facility | None | $436.52 | $1,698.24 | $2,754.23 |
Cigna Setting Professional Modifier None Typical Low $257.04 Median $338.84 Typical High $645.65 | Professional | None | $257.04 | $338.84 | $645.65 |
Florida Blue Setting Facility Modifier None Typical Low $977.24 Median $2,089.30 Typical High $16,982.44 | Facility | None | $977.24 | $2,089.30 | $16,982.44 |
Florida Blue Setting Professional Modifier None Typical Low $177.83 Median $331.13 Typical High $512.86 | Professional | None | $177.83 | $331.13 | $512.86 |
Molina Setting Professional Modifier None Typical Low $31.62 Median $288.40 Typical High $562.34 | Professional | None | $31.62 | $288.40 | $562.34 |
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 $269.15 Median $371.54 Typical High $741.31 | Professional | None | $269.15 | $371.54 | $741.31 |
Wellpoint Setting Professional Modifier None Typical Low $263.03 Median $371.54 Typical High $371.54 | Professional | None | $263.03 | $371.54 | $371.54 |
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 $162.18 Median $194.98 Typical High $245.47 | Professional | 52 · Reduced service | $162.18 | $194.98 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $64.57 Median $77.62 Typical High $97.72 | Professional | 53 · Discontinued | $64.57 | $77.62 | $97.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $239.88 Median $295.12 Typical High $363.08 | Professional | 54 · Surgery only | $239.88 | $295.12 | $363.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $58.88 Typical High $72.44 | Professional | 55 · Aftercare only | $47.86 | $58.88 | $72.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $38.90 Typical High $48.98 | Professional | 56 · Pre-op care only | $32.36 | $38.90 | $48.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $223.87 Median $275.42 Typical High $338.84 | Professional | 78 · Unplanned return to OR | $223.87 | $275.42 | $338.84 |
Ambetter Setting Professional Modifier 58 · Staged procedure Typical Low $457.09 Median $457.09 Typical High $457.09 | Professional | 58 · Staged procedure | $457.09 | $457.09 | $457.09 |
Where Florida sits
The same service costs 6.0 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
$372
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.