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 $549.54 Median $3,801.89 Typical High $10,964.78 | Facility | None | $549.54 | $3,801.89 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $316.23 Median $537.03 Typical High $707.95 | Professional | None | $316.23 | $537.03 | $707.95 |
AvMed Setting Facility Modifier None Typical Low $489.78 Median $1,819.70 Typical High $9,549.93 | Facility | None | $489.78 | $1,819.70 | $9,549.93 |
AvMed Setting Professional Modifier None Typical Low $346.74 Median $524.81 Typical High $691.83 | Professional | None | $346.74 | $524.81 | $691.83 |
Cigna Setting Facility Modifier None Typical Low $436.52 Median $2,818.38 Typical High $5,370.32 | Facility | None | $436.52 | $2,818.38 | $5,370.32 |
Cigna Setting Professional Modifier None Typical Low $245.47 Median $426.58 Typical High $851.14 | Professional | None | $245.47 | $426.58 | $851.14 |
Florida Blue Setting Facility Modifier None Typical Low $1,737.80 Median $3,548.13 Typical High $16,982.44 | Facility | None | $1,737.80 | $3,548.13 | $16,982.44 |
Florida Blue Setting Professional Modifier None Typical Low $269.15 Median $457.09 Typical High $676.08 | Professional | None | $269.15 | $457.09 | $676.08 |
Molina Setting Professional Modifier None Typical Low $31.62 Median $389.05 Typical High $758.58 | Professional | None | $31.62 | $389.05 | $758.58 |
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 $257.04 Median $467.74 Typical High $954.99 | Professional | None | $257.04 | $467.74 | $954.99 |
Wellpoint Setting Professional Modifier None Typical Low $257.04 Median $489.78 Typical High $489.78 | Professional | None | $257.04 | $489.78 | $489.78 |
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 $158.49 Median $269.15 Typical High $354.81 | Professional | 52 · Reduced service | $158.49 | $269.15 | $354.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $107.15 Typical High $141.25 | Professional | 53 · Discontinued | $63.10 | $107.15 | $141.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $234.42 Median $407.38 Typical High $537.03 | Professional | 54 · Surgery only | $234.42 | $407.38 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $46.77 Median $81.28 Typical High $107.15 | Professional | 55 · Aftercare only | $46.77 | $81.28 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $53.70 Typical High $70.79 | Professional | 56 · Pre-op care only | $31.62 | $53.70 | $70.79 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $218.78 Median $380.19 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $218.78 | $380.19 | $501.19 |
Where Florida sits
The same service costs 4.9 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· 45th of 51
$468
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.