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 $501.19 Median $3,090.30 Typical High $10,964.78 | Facility | None | $501.19 | $3,090.30 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $257.04 Median $436.52 Typical High $645.65 | Professional | None | $257.04 | $436.52 | $645.65 |
AvMed Setting Facility Modifier None Typical Low $489.78 Median $1,819.70 Typical High $9,772.37 | Facility | None | $489.78 | $1,819.70 | $9,772.37 |
AvMed Setting Professional Modifier None Typical Low $331.13 Median $575.44 Typical High $776.25 | Professional | None | $331.13 | $575.44 | $776.25 |
Cigna Setting Facility Modifier None Typical Low $436.52 Median $2,818.38 Typical High $5,370.32 | Facility | None | $436.52 | $2,818.38 | $5,370.32 |
Cigna Setting Professional Modifier None Typical Low $316.23 Median $512.86 Typical High $812.83 | Professional | None | $316.23 | $512.86 | $812.83 |
Florida Blue Setting Facility Modifier None Typical Low $660.69 Median $1,412.54 Typical High $16,982.44 | Facility | None | $660.69 | $1,412.54 | $16,982.44 |
Florida Blue Setting Professional Modifier None Typical Low $223.87 Median $501.19 Typical High $794.33 | Professional | None | $223.87 | $501.19 | $794.33 |
Molina Setting Professional Modifier None Typical Low $63.10 Median $457.09 Typical High $831.76 | Professional | None | $63.10 | $457.09 | $831.76 |
United Setting Facility Modifier None Typical Low $398.11 Median $1,000.00 Typical High $5,754.40 | Facility | None | $398.11 | $1,000.00 | $5,754.40 |
United Setting Professional Modifier None Typical Low $269.15 Median $467.74 Typical High $912.01 | Professional | None | $269.15 | $467.74 | $912.01 |
Wellpoint Setting Professional Modifier None Typical Low $346.74 Median $363.08 Typical High $363.08 | Professional | None | $346.74 | $363.08 | $363.08 |
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 $128.82 Median $218.78 Typical High $323.59 | Professional | 52 · Reduced service | $128.82 | $218.78 | $323.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $51.29 Median $87.10 Typical High $128.82 | Professional | 53 · Discontinued | $51.29 | $87.10 | $128.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $194.98 Median $331.13 Typical High $478.63 | Professional | 54 · Surgery only | $194.98 | $331.13 | $478.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $66.07 Typical High $95.50 | Professional | 55 · Aftercare only | $38.90 | $66.07 | $95.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $43.65 Typical High $64.57 | Professional | 56 · Pre-op care only | $25.70 | $43.65 | $64.57 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $181.97 Median $309.03 Typical High $446.68 | Professional | 78 · Unplanned return to OR | $181.97 | $309.03 | $446.68 |
Where Florida sits
The same service costs 5.9 times more in Alaska than in Kentucky. 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
$501
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.