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 $794.33 Median $6,456.54 Typical High $14,791.08 | Facility | None | $794.33 | $6,456.54 | $14,791.08 |
Aetna Setting Professional Modifier None Typical Low $676.08 Median $794.33 Typical High $933.25 | Professional | None | $676.08 | $794.33 | $933.25 |
AvMed Setting Facility Modifier None Typical Low $794.33 Median $2,951.21 Typical High $9,772.37 | Facility | None | $794.33 | $2,951.21 | $9,772.37 |
AvMed Setting Professional Modifier None Typical Low $630.96 Median $812.83 Typical High $933.25 | Professional | None | $630.96 | $812.83 | $933.25 |
Cigna Setting Facility Modifier None Typical Low $977.24 Median $5,248.07 Typical High $8,912.51 | Facility | None | $977.24 | $5,248.07 | $8,912.51 |
Cigna Setting Professional Modifier None Typical Low $602.56 Median $630.96 Typical High $1,318.26 | Professional | None | $602.56 | $630.96 | $1,318.26 |
Florida Blue Setting Facility Modifier None Typical Low $1,778.28 Median $3,548.13 Typical High $16,982.44 | Facility | None | $1,778.28 | $3,548.13 | $16,982.44 |
Florida Blue Setting Professional Modifier None Typical Low $346.74 Median $741.31 Typical High $1,000.00 | Professional | None | $346.74 | $741.31 | $1,000.00 |
Molina Setting Professional Modifier None Typical Low $60.26 Median $489.78 Typical High $933.25 | Professional | None | $60.26 | $489.78 | $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 $562.34 Median $724.44 Typical High $1,412.54 | Professional | None | $562.34 | $724.44 | $1,412.54 |
Wellpoint Setting Professional Modifier None Typical Low $602.56 Median $602.56 Typical High $794.33 | Professional | None | $602.56 | $602.56 | $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 $338.84 Median $398.11 Typical High $467.74 | Professional | 52 · Reduced service | $338.84 | $398.11 | $467.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $158.49 Typical High $186.21 | Professional | 53 · Discontinued | $134.90 | $158.49 | $186.21 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $588.84 Typical High $707.95 | Professional | 54 · Surgery only | $512.86 | $588.84 | $707.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $117.49 Typical High $141.25 | Professional | 55 · Aftercare only | $102.33 | $117.49 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $79.43 Typical High $93.33 | Professional | 56 · Pre-op care only | $67.61 | $79.43 | $93.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $549.54 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $478.63 | $549.54 | $660.69 |
Where Florida sits
The same service costs 17.8 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
$692
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.