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 $5,495.41 Typical High $12,302.69 | Facility | None | $707.95 | $5,495.41 | $12,302.69 |
Aetna Setting Professional Modifier None Typical Low $630.96 Median $707.95 Typical High $1,000.00 | Professional | None | $630.96 | $707.95 | $1,000.00 |
AvMed Setting Facility Modifier None Typical Low $741.31 Median $4,265.80 Typical High $13,182.57 | Facility | None | $741.31 | $4,265.80 | $13,182.57 |
AvMed Setting Professional Modifier None Typical Low $707.95 Median $831.76 Typical High $1,047.13 | Professional | None | $707.95 | $831.76 | $1,047.13 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $8,912.51 Typical High $16,982.44 | Facility | None | $512.86 | $8,912.51 | $16,982.44 |
Cigna Setting Professional Modifier None Typical Low $660.69 Median $707.95 Typical High $1,348.96 | Professional | None | $660.69 | $707.95 | $1,348.96 |
Florida Blue Setting Facility Modifier None Typical Low $6,760.83 Median $12,302.69 Typical High $22,908.68 | Facility | None | $6,760.83 | $12,302.69 | $22,908.68 |
Florida Blue Setting Professional Modifier None Typical Low $316.23 Median $724.44 Typical High $1,023.29 | Professional | None | $316.23 | $724.44 | $1,023.29 |
Molina Setting Professional Modifier None Typical Low $60.26 Median $575.44 Typical High $1,047.13 | Professional | None | $60.26 | $575.44 | $1,047.13 |
United Setting Facility Modifier None Typical Low $1,584.89 Median $4,073.80 Typical High $15,848.93 | Facility | None | $1,584.89 | $4,073.80 | $15,848.93 |
United Setting Professional Modifier None Typical Low $588.84 Median $758.58 Typical High $1,548.82 | Professional | None | $588.84 | $758.58 | $1,548.82 |
Wellpoint Setting Professional Modifier None Typical Low $602.56 Median $602.56 Typical High $891.25 | Professional | None | $602.56 | $602.56 | $891.25 |
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 $316.23 Median $354.81 Typical High $501.19 | Professional | 52 · Reduced service | $316.23 | $354.81 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $141.25 Typical High $199.53 | Professional | 53 · Discontinued | $125.89 | $141.25 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $524.81 Typical High $741.31 | Professional | 54 · Surgery only | $467.74 | $524.81 | $741.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $104.71 Typical High $147.91 | Professional | 55 · Aftercare only | $95.50 | $104.71 | $147.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $70.79 Typical High $100.00 | Professional | 56 · Pre-op care only | $63.10 | $70.79 | $100.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $489.78 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $436.52 | $489.78 | $691.83 |
Where Florida sits
The same service costs 16.2 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
$708
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.