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 $4,786.30 Typical High $11,748.98 | Facility | None | $776.25 | $4,786.30 | $11,748.98 |
Aetna Setting Professional Modifier None Typical Low $870.96 Median $912.01 Typical High $1,096.48 | Professional | None | $870.96 | $912.01 | $1,096.48 |
AvMed Setting Facility Modifier None Typical Low $776.25 Median $2,137.96 Typical High $9,772.37 | Facility | None | $776.25 | $2,137.96 | $9,772.37 |
AvMed Setting Professional Modifier None Typical Low $776.25 Median $1,047.13 Typical High $1,202.26 | Professional | None | $776.25 | $1,047.13 | $1,202.26 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $3,467.37 Typical High $6,606.93 | Facility | None | $501.19 | $3,467.37 | $6,606.93 |
Cigna Setting Professional Modifier None Typical Low $741.31 Median $776.25 Typical High $1,621.81 | Professional | None | $741.31 | $776.25 | $1,621.81 |
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 $436.52 Median $933.25 Typical High $1,230.27 | Professional | None | $436.52 | $933.25 | $1,230.27 |
Molina Setting Professional Modifier None Typical Low $60.26 Median $602.56 Typical High $1,122.02 | Professional | None | $60.26 | $602.56 | $1,122.02 |
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 $691.83 Median $891.25 Typical High $1,698.24 | Professional | None | $691.83 | $891.25 | $1,698.24 |
Wellpoint Setting Professional Modifier None Typical Low $724.44 Median $724.44 Typical High $977.24 | Professional | None | $724.44 | $724.44 | $977.24 |
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 $426.58 Median $457.09 Typical High $549.54 | Professional | 52 · Reduced service | $426.58 | $457.09 | $549.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $181.97 Typical High $218.78 | Professional | 53 · Discontinued | $173.78 | $181.97 | $218.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $676.08 Typical High $831.76 | Professional | 54 · Surgery only | $645.65 | $676.08 | $831.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $134.90 Typical High $165.96 | Professional | 55 · Aftercare only | $128.82 | $134.90 | $165.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $91.20 Typical High $109.65 | Professional | 56 · Pre-op care only | $87.10 | $91.20 | $109.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $630.96 Typical High $776.25 | Professional | 78 · Unplanned return to OR | $602.56 | $630.96 | $776.25 |
Where Florida sits
The same service costs 8.3 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
$851
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.