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 $776.25 Median $6,025.60 Typical High $12,882.50 | Facility | None | $776.25 | $6,025.60 | $12,882.50 |
Aetna Setting Professional Modifier None Typical Low $724.44 Median $812.83 Typical High $977.24 | Professional | None | $724.44 | $812.83 | $977.24 |
AvMed Setting Facility Modifier None Typical Low $707.95 Median $2,454.71 Typical High $10,000.00 | Facility | None | $707.95 | $2,454.71 | $10,000.00 |
AvMed Setting Professional Modifier None Typical Low $691.83 Median $912.01 Typical High $1,047.13 | Professional | None | $691.83 | $912.01 | $1,047.13 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $4,897.79 Typical High $9,120.11 | Facility | None | $707.95 | $4,897.79 | $9,120.11 |
Cigna Setting Professional Modifier None Typical Low $660.69 Median $691.83 Typical High $1,412.54 | Professional | None | $660.69 | $691.83 | $1,412.54 |
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 $371.54 Median $831.76 Typical High $1,000.00 | Professional | None | $371.54 | $831.76 | $1,000.00 |
Molina Setting Professional Modifier None Typical Low $60.26 Median $575.44 Typical High $1,023.29 | Professional | None | $60.26 | $575.44 | $1,023.29 |
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 $616.60 Median $776.25 Typical High $1,513.56 | Professional | None | $616.60 | $776.25 | $1,513.56 |
Wellpoint Setting Professional Modifier None Typical Low $645.65 Median $645.65 Typical High $870.96 | Professional | None | $645.65 | $645.65 | $870.96 |
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 $363.08 Median $398.11 Typical High $478.63 | Professional | 52 · Reduced service | $363.08 | $398.11 | $478.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $162.18 Typical High $190.55 | Professional | 53 · Discontinued | $147.91 | $162.18 | $190.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $602.56 Typical High $724.44 | Professional | 54 · Surgery only | $549.54 | $602.56 | $724.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $120.23 Typical High $144.54 | Professional | 55 · Aftercare only | $109.65 | $120.23 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $81.28 Typical High $95.50 | Professional | 56 · Pre-op care only | $72.44 | $81.28 | $95.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $562.34 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $512.86 | $562.34 | $676.08 |
Where Florida sits
The same service costs 7.9 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
$759
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.