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 $630.96 Median $4,786.30 Typical High $11,748.98 | Facility | None | $630.96 | $4,786.30 | $11,748.98 |
Aetna Setting Professional Modifier None Typical Low $489.78 Median $537.03 Typical High $676.08 | Professional | None | $489.78 | $537.03 | $676.08 |
AvMed Setting Facility Modifier None Typical Low $512.86 Median $2,089.30 Typical High $9,772.37 | Facility | None | $512.86 | $2,089.30 | $9,772.37 |
AvMed Setting Professional Modifier None Typical Low $489.78 Median $616.60 Typical High $691.83 | Professional | None | $489.78 | $616.60 | $691.83 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $1,905.46 Typical High $2,951.21 | Facility | None | $501.19 | $1,905.46 | $2,951.21 |
Cigna Setting Professional Modifier None Typical Low $446.68 Median $478.63 Typical High $954.99 | Professional | None | $446.68 | $478.63 | $954.99 |
Florida Blue Setting Facility Modifier None Typical Low $1,230.27 Median $2,630.27 Typical High $16,982.44 | Facility | None | $1,230.27 | $2,630.27 | $16,982.44 |
Florida Blue Setting Professional Modifier None Typical Low $251.19 Median $549.54 Typical High $660.69 | Professional | None | $251.19 | $549.54 | $660.69 |
Molina Setting Professional Modifier None Typical Low $60.26 Median $371.54 Typical High $724.44 | Professional | None | $60.26 | $371.54 | $724.44 |
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 $407.38 Median $524.81 Typical High $1,023.29 | Professional | None | $407.38 | $524.81 | $1,023.29 |
Wellpoint Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $616.60 | Professional | None | $467.74 | $467.74 | $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 $245.47 Median $269.15 Typical High $331.13 | Professional | 52 · Reduced service | $245.47 | $269.15 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $107.15 Typical High $131.83 | Professional | 53 · Discontinued | $97.72 | $107.15 | $131.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $407.38 Typical High $489.78 | Professional | 54 · Surgery only | $371.54 | $407.38 | $489.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $81.28 Typical High $100.00 | Professional | 55 · Aftercare only | $74.13 | $81.28 | $100.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $53.70 Typical High $66.07 | Professional | 56 · Pre-op care only | $48.98 | $53.70 | $66.07 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $346.74 Median $380.19 Typical High $457.09 | Professional | 78 · Unplanned return to OR | $346.74 | $380.19 | $457.09 |
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· 47th of 51
$525
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.