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 $5,128.61 Typical High $14,454.40 | Facility | None | $707.95 | $5,128.61 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $512.86 Median $616.60 Typical High $794.33 | Professional | None | $512.86 | $616.60 | $794.33 |
AvMed Setting Facility Modifier None Typical Low $645.65 Median $2,691.53 Typical High $9,549.93 | Facility | None | $645.65 | $2,691.53 | $9,549.93 |
AvMed Setting Professional Modifier None Typical Low $602.56 Median $707.95 Typical High $891.25 | Professional | None | $602.56 | $707.95 | $891.25 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $954.99 Typical High $5,248.07 | Facility | None | $645.65 | $954.99 | $5,248.07 |
Cigna Setting Professional Modifier None Typical Low $457.09 Median $602.56 Typical High $1,071.52 | Professional | None | $457.09 | $602.56 | $1,071.52 |
Florida Blue Setting Facility Modifier None Typical Low $977.24 Median $2,187.76 Typical High $6,309.57 | Facility | None | $977.24 | $2,187.76 | $6,309.57 |
Florida Blue Setting Professional Modifier None Typical Low $316.23 Median $660.69 Typical High $870.96 | Professional | None | $316.23 | $660.69 | $870.96 |
Molina Setting Professional Modifier None Typical Low $66.07 Median $512.86 Typical High $912.01 | Professional | None | $66.07 | $512.86 | $912.01 |
United Setting Facility Modifier None Typical Low $398.11 Median $1,000.00 Typical High $5,623.41 | Facility | None | $398.11 | $1,000.00 | $5,623.41 |
United Setting Professional Modifier None Typical Low $446.68 Median $602.56 Typical High $1,202.26 | Professional | None | $446.68 | $602.56 | $1,202.26 |
Wellpoint Setting Professional Modifier None Typical Low $446.68 Median $616.60 Typical High $616.60 | Professional | None | $446.68 | $616.60 | $616.60 |
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 $257.04 Median $309.03 Typical High $398.11 | Professional | 52 · Reduced service | $257.04 | $309.03 | $398.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $125.89 Typical High $158.49 | Professional | 53 · Discontinued | $104.71 | $125.89 | $158.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $467.74 Typical High $602.56 | Professional | 54 · Surgery only | $389.05 | $467.74 | $602.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $93.33 Typical High $120.23 | Professional | 55 · Aftercare only | $77.62 | $93.33 | $120.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $61.66 Typical High $79.43 | Professional | 56 · Pre-op care only | $51.29 | $61.66 | $79.43 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $363.08 Median $436.52 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $363.08 | $436.52 | $562.34 |
Where Florida sits
The same service costs 5.6 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
$617
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.