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 $5,495.41 Typical High $14,454.40 | Facility | None | $707.95 | $5,495.41 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $489.78 Median $588.84 Typical High $758.58 | Professional | None | $489.78 | $588.84 | $758.58 |
AvMed Setting Facility Modifier None Typical Low $562.34 Median $2,818.38 Typical High $9,549.93 | Facility | None | $562.34 | $2,818.38 | $9,549.93 |
AvMed Setting Professional Modifier None Typical Low $512.86 Median $630.96 Typical High $741.31 | Professional | None | $512.86 | $630.96 | $741.31 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $2,511.89 Typical High $5,248.07 | Facility | None | $954.99 | $2,511.89 | $5,248.07 |
Cigna Setting Professional Modifier None Typical Low $371.54 Median $467.74 Typical High $977.24 | Professional | None | $371.54 | $467.74 | $977.24 |
Florida Blue Setting Facility Modifier None Typical Low $1,071.52 Median $2,089.30 Typical High $16,982.44 | Facility | None | $1,071.52 | $2,089.30 | $16,982.44 |
Florida Blue Setting Professional Modifier None Typical Low $288.40 Median $588.84 Typical High $707.95 | Professional | None | $288.40 | $588.84 | $707.95 |
Molina Setting Professional Modifier None Typical Low $64.57 Median $426.58 Typical High $776.25 | Professional | None | $64.57 | $426.58 | $776.25 |
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 $398.11 Median $549.54 Typical High $1,071.52 | Professional | None | $398.11 | $549.54 | $1,071.52 |
Wellpoint Setting Professional Modifier None Typical Low $380.19 Median $501.19 Typical High $501.19 | Professional | None | $380.19 | $501.19 | $501.19 |
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 $245.47 Median $295.12 Typical High $354.81 | Professional | 52 · Reduced service | $245.47 | $295.12 | $354.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $117.49 Typical High $141.25 | Professional | 53 · Discontinued | $97.72 | $117.49 | $141.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $446.68 Typical High $524.81 | Professional | 54 · Surgery only | $371.54 | $446.68 | $524.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $89.13 Typical High $104.71 | Professional | 55 · Aftercare only | $74.13 | $89.13 | $104.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $58.88 Typical High $70.79 | Professional | 56 · Pre-op care only | $48.98 | $58.88 | $70.79 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $346.74 Median $416.87 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $346.74 | $416.87 | $489.78 |
Where Florida sits
The same service costs 6.2 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
$562
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.