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 $12,882.50 | Facility | None | $707.95 | $5,495.41 | $12,882.50 |
Aetna Setting Professional Modifier None Typical Low $524.81 Median $660.69 Typical High $831.76 | Professional | None | $524.81 | $660.69 | $831.76 |
AvMed Setting Facility Modifier None Typical Low $630.96 Median $2,344.23 Typical High $9,772.37 | Facility | None | $630.96 | $2,344.23 | $9,772.37 |
AvMed Setting Professional Modifier None Typical Low $575.44 Median $691.83 Typical High $870.96 | Professional | None | $575.44 | $691.83 | $870.96 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $3,311.31 Typical High $5,370.32 | Facility | None | $707.95 | $3,311.31 | $5,370.32 |
Cigna Setting Professional Modifier None Typical Low $436.52 Median $588.84 Typical High $1,047.13 | Professional | None | $436.52 | $588.84 | $1,047.13 |
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 $338.84 Median $588.84 Typical High $851.14 | Professional | None | $338.84 | $588.84 | $851.14 |
Molina Setting Professional Modifier None Typical Low $91.20 Median $512.86 Typical High $933.25 | Professional | None | $91.20 | $512.86 | $933.25 |
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 $426.58 Median $602.56 Typical High $1,202.26 | Professional | None | $426.58 | $602.56 | $1,202.26 |
Wellpoint Setting Professional Modifier None Typical Low $549.54 Median $794.33 Typical High $794.33 | Professional | None | $549.54 | $794.33 | $794.33 |
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 $263.03 Median $331.13 Typical High $398.11 | Professional | 52 · Reduced service | $263.03 | $331.13 | $398.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $131.83 Typical High $158.49 | Professional | 53 · Discontinued | $104.71 | $131.83 | $158.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $398.11 Median $501.19 Typical High $602.56 | Professional | 54 · Surgery only | $398.11 | $501.19 | $602.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $100.00 Typical High $120.23 | Professional | 55 · Aftercare only | $79.43 | $100.00 | $120.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $66.07 Typical High $79.43 | Professional | 56 · Pre-op care only | $52.48 | $66.07 | $79.43 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $371.54 Median $467.74 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $371.54 | $467.74 | $562.34 |
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
$631
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.