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 $416.87 Median $3,090.30 Typical High $11,481.54 | Facility | None | $416.87 | $3,090.30 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $371.54 Median $416.87 Typical High $537.03 | Professional | None | $371.54 | $416.87 | $537.03 |
AvMed Setting Facility Modifier None Typical Low $239.88 Median $1,348.96 Typical High $9,549.93 | Facility | None | $239.88 | $1,348.96 | $9,549.93 |
AvMed Setting Professional Modifier None Typical Low $389.05 Median $489.78 Typical High $549.54 | Professional | None | $389.05 | $489.78 | $549.54 |
Cigna Setting Facility Modifier None Typical Low $323.59 Median $1,023.29 Typical High $1,659.59 | Facility | None | $323.59 | $1,023.29 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $354.81 Median $380.19 Typical High $741.31 | Professional | None | $354.81 | $380.19 | $741.31 |
Florida Blue Setting Facility Modifier None Typical Low $724.44 Median $1,621.81 Typical High $6,309.57 | Facility | None | $724.44 | $1,621.81 | $6,309.57 |
Florida Blue Setting Professional Modifier None Typical Low $190.55 Median $436.52 Typical High $524.81 | Professional | None | $190.55 | $436.52 | $524.81 |
Molina Setting Professional Modifier None Typical Low $60.26 Median $316.23 Typical High $588.84 | Professional | None | $60.26 | $316.23 | $588.84 |
United Setting Facility Modifier None Typical Low $398.11 Median $1,000.00 Typical High $5,623.41 | Facility | None | $398.11 | $1,000.00 | $5,623.41 |
United Setting Professional Modifier None Typical Low $316.23 Median $407.38 Typical High $812.83 | Professional | None | $316.23 | $407.38 | $812.83 |
Wellpoint Setting Professional Modifier None Typical Low $371.54 Median $371.54 Typical High $489.78 | Professional | None | $371.54 | $371.54 | $489.78 |
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 $186.21 Median $208.93 Typical High $263.03 | Professional | 52 · Reduced service | $186.21 | $208.93 | $263.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $74.13 Median $83.18 Typical High $104.71 | Professional | 53 · Discontinued | $74.13 | $83.18 | $104.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $275.42 Median $309.03 Typical High $398.11 | Professional | 54 · Surgery only | $275.42 | $309.03 | $398.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $61.66 Typical High $79.43 | Professional | 55 · Aftercare only | $54.95 | $61.66 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $41.69 Typical High $52.48 | Professional | 56 · Pre-op care only | $37.15 | $41.69 | $52.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $257.04 Median $288.40 Typical High $371.54 | Professional | 78 · Unplanned return to OR | $257.04 | $288.40 | $371.54 |
Where Florida sits
The same service costs 7.6 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
$407
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.