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 $1,202.26 Median $1,479.11 Typical High $8,709.64 | Facility | None | $1,202.26 | $1,479.11 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $1,148.15 Median $1,348.96 Typical High $1,621.81 | Professional | None | $1,148.15 | $1,348.96 | $1,621.81 |
AvMed Setting Facility Modifier None Typical Low $794.33 Median $2,137.96 Typical High $11,748.98 | Facility | None | $794.33 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $1,122.02 Median $1,445.44 Typical High $1,778.28 | Professional | None | $1,122.02 | $1,445.44 | $1,778.28 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $933.25 Typical High $2,691.53 | Facility | None | $501.19 | $933.25 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $851.14 Median $1,122.02 Typical High $2,238.72 | Professional | None | $851.14 | $1,122.02 | $2,238.72 |
Florida Blue Setting Facility Modifier None Typical Low $912.01 Median $1,949.84 Typical High $16,982.44 | Facility | None | $912.01 | $1,949.84 | $16,982.44 |
Florida Blue Setting Professional Modifier None Typical Low $676.08 Median $1,513.56 Typical High $1,819.70 | Professional | None | $676.08 | $1,513.56 | $1,819.70 |
Molina Setting Professional Modifier None Typical Low $131.83 Median $1,023.29 Typical High $1,905.46 | Professional | None | $131.83 | $1,023.29 | $1,905.46 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $3,311.31 Typical High $12,589.25 | Facility | None | $1,230.27 | $3,311.31 | $12,589.25 |
United Setting Professional Modifier None Typical Low $891.25 Median $1,288.25 Typical High $2,511.89 | Professional | None | $891.25 | $1,288.25 | $2,511.89 |
Wellpoint Setting Professional Modifier None Typical Low $831.76 Median $1,258.93 Typical High $1,258.93 | Professional | None | $831.76 | $1,258.93 | $1,258.93 |
5 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 $575.44 Median $676.08 Typical High $812.83 | Professional | 52 · Reduced service | $575.44 | $676.08 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $229.09 Median $269.15 Typical High $323.59 | Professional | 53 · Discontinued | $229.09 | $269.15 | $323.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $204.17 Typical High $245.47 | Professional | 55 · Aftercare only | $173.78 | $204.17 | $245.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $134.90 Typical High $162.18 | Professional | 56 · Pre-op care only | $114.82 | $134.90 | $162.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $794.33 Median $954.99 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $794.33 | $954.99 | $1,148.15 |
Where Florida sits
The same service costs 5.1 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
$1,259
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.