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 $1,148.15 Median $6,025.60 Typical High $12,022.64 | Facility | None | $1,148.15 | $6,025.60 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $1,122.02 Median $1,202.26 Typical High $1,513.56 | Professional | None | $1,122.02 | $1,202.26 | $1,513.56 |
AvMed Setting Facility Modifier None Typical Low $977.24 Median $2,818.38 Typical High $11,748.98 | Facility | None | $977.24 | $2,818.38 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $977.24 Median $1,288.25 Typical High $1,479.11 | Professional | None | $977.24 | $1,288.25 | $1,479.11 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $2,951.21 Typical High $5,370.32 | Facility | None | $512.86 | $2,951.21 | $5,370.32 |
Cigna Setting Professional Modifier None Typical Low $933.25 Median $977.24 Typical High $2,041.74 | Professional | None | $933.25 | $977.24 | $2,041.74 |
Florida Blue Setting Facility Modifier None Typical Low $891.25 Median $1,819.70 Typical High $16,982.44 | Facility | None | $891.25 | $1,819.70 | $16,982.44 |
Florida Blue Setting Professional Modifier None Typical Low $575.44 Median $1,148.15 Typical High $1,348.96 | Professional | None | $575.44 | $1,148.15 | $1,348.96 |
Molina Setting Professional Modifier None Typical Low $91.20 Median $758.58 Typical High $1,412.54 | Professional | None | $91.20 | $758.58 | $1,412.54 |
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 $870.96 Median $1,148.15 Typical High $2,238.72 | Professional | None | $870.96 | $1,148.15 | $2,238.72 |
Wellpoint Setting Professional Modifier None Typical Low $933.25 Median $933.25 Typical High $1,230.27 | Professional | None | $933.25 | $933.25 | $1,230.27 |
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 $562.34 Median $602.56 Typical High $724.44 | Professional | 52 · Reduced service | $562.34 | $602.56 | $724.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $239.88 Typical High $288.40 | Professional | 53 · Discontinued | $223.87 | $239.88 | $288.40 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $851.14 Median $912.01 Typical High $1,071.52 | Professional | 54 · Surgery only | $851.14 | $912.01 | $1,071.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $169.82 Median $181.97 Typical High $213.80 | Professional | 55 · Aftercare only | $169.82 | $181.97 | $213.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $120.23 Typical High $144.54 | Professional | 56 · Pre-op care only | $112.20 | $120.23 | $144.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $794.33 Median $851.14 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $794.33 | $851.14 | $1,000.00 |
Where Florida sits
The same service costs 15.1 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· 48th of 51
$1,047
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.