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 $758.58 Median $6,025.60 Typical High $12,882.50 | Facility | None | $758.58 | $6,025.60 | $12,882.50 |
Aetna Setting Professional Modifier None Typical Low $537.03 Median $602.56 Typical High $741.31 | Professional | None | $537.03 | $602.56 | $741.31 |
AvMed Setting Facility Modifier None Typical Low $602.56 Median $2,398.83 Typical High $9,772.37 | Facility | None | $602.56 | $2,398.83 | $9,772.37 |
AvMed Setting Professional Modifier None Typical Low $524.81 Median $691.83 Typical High $776.25 | Professional | None | $524.81 | $691.83 | $776.25 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $3,801.89 Typical High $6,606.93 | Facility | None | $707.95 | $3,801.89 | $6,606.93 |
Cigna Setting Professional Modifier None Typical Low $489.78 Median $524.81 Typical High $1,047.13 | Professional | None | $489.78 | $524.81 | $1,047.13 |
Florida Blue Setting Facility Modifier None Typical Low $1,318.26 Median $2,630.27 Typical High $16,982.44 | Facility | None | $1,318.26 | $2,630.27 | $16,982.44 |
Florida Blue Setting Professional Modifier None Typical Low $275.42 Median $602.56 Typical High $758.58 | Professional | None | $275.42 | $602.56 | $758.58 |
Molina Setting Professional Modifier None Typical Low $60.26 Median $416.87 Typical High $776.25 | Professional | None | $60.26 | $416.87 | $776.25 |
United Setting Facility Modifier None Typical Low $954.99 Median $2,344.23 Typical High $10,000.00 | Facility | None | $954.99 | $2,344.23 | $10,000.00 |
United Setting Professional Modifier None Typical Low $457.09 Median $588.84 Typical High $1,122.02 | Professional | None | $457.09 | $588.84 | $1,122.02 |
Wellpoint Setting Professional Modifier None Typical Low $501.19 Median $501.19 Typical High $660.69 | Professional | None | $501.19 | $501.19 | $660.69 |
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 $269.15 Median $295.12 Typical High $363.08 | Professional | 52 · Reduced service | $269.15 | $295.12 | $363.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $120.23 Typical High $144.54 | Professional | 53 · Discontinued | $109.65 | $120.23 | $144.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $407.38 Median $446.68 Typical High $537.03 | Professional | 54 · Surgery only | $407.38 | $446.68 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $89.13 Typical High $107.15 | Professional | 55 · Aftercare only | $81.28 | $89.13 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $60.26 Typical High $72.44 | Professional | 56 · Pre-op care only | $53.70 | $60.26 | $72.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $380.19 Median $416.87 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $380.19 | $416.87 | $501.19 |
Where Florida sits
The same service costs 7.8 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
$575
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.