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 $645.65 Median $4,677.35 Typical High $11,748.98 | Facility | None | $645.65 | $4,677.35 | $11,748.98 |
Aetna Setting Professional Modifier None Typical Low $512.86 Median $645.65 Typical High $794.33 | Professional | None | $512.86 | $645.65 | $794.33 |
AvMed Setting Facility Modifier None Typical Low $588.84 Median $2,089.30 Typical High $9,772.37 | Facility | None | $588.84 | $2,089.30 | $9,772.37 |
AvMed Setting Professional Modifier None Typical Low $575.44 Median $707.95 Typical High $812.83 | Professional | None | $575.44 | $707.95 | $812.83 |
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 $524.81 Median $562.34 Typical High $1,071.52 | Professional | None | $524.81 | $562.34 | $1,071.52 |
Florida Blue Setting Facility Modifier None Typical Low $1,659.59 Median $3,548.13 Typical High $16,982.44 | Facility | None | $1,659.59 | $3,548.13 | $16,982.44 |
Florida Blue Setting Professional Modifier None Typical Low $257.04 Median $588.84 Typical High $831.76 | Professional | None | $257.04 | $588.84 | $831.76 |
Molina Setting Professional Modifier None Typical Low $60.26 Median $436.52 Typical High $812.83 | Professional | None | $60.26 | $436.52 | $812.83 |
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 $467.74 Median $616.60 Typical High $1,202.26 | Professional | None | $467.74 | $616.60 | $1,202.26 |
Wellpoint Setting Professional Modifier None Typical Low $537.03 Median $537.03 Typical High $707.95 | Professional | None | $537.03 | $537.03 | $707.95 |
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 $257.04 Median $323.59 Typical High $389.05 | Professional | 52 · Reduced service | $257.04 | $323.59 | $389.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $128.82 Typical High $154.88 | Professional | 53 · Discontinued | $102.33 | $128.82 | $154.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $489.78 Typical High $575.44 | Professional | 54 · Surgery only | $380.19 | $489.78 | $575.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $97.72 Typical High $114.82 | Professional | 55 · Aftercare only | $75.86 | $97.72 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $64.57 Typical High $77.62 | Professional | 56 · Pre-op care only | $51.29 | $64.57 | $77.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $354.81 Median $457.09 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $354.81 | $457.09 | $537.03 |
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
$603
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.