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 $5,495.41 Typical High $12,022.64 | Facility | None | $776.25 | $5,495.41 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $676.08 Median $758.58 Typical High $933.25 | Professional | None | $676.08 | $758.58 | $933.25 |
Ambetter Setting Professional Modifier None Typical Low $794.33 Median $1,258.93 Typical High $1,258.93 | Professional | None | $794.33 | $1,258.93 | $1,258.93 |
AvMed Setting Facility Modifier None Typical Low $707.95 Median $2,137.96 Typical High $11,748.98 | Facility | None | $707.95 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $676.08 Median $831.76 Typical High $954.99 | Professional | None | $676.08 | $831.76 | $954.99 |
Cigna Setting Facility Modifier None Typical Low $616.60 Median $1,905.46 Typical High $3,311.31 | Facility | None | $616.60 | $1,905.46 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $616.60 Median $660.69 Typical High $1,318.26 | Professional | None | $616.60 | $660.69 | $1,318.26 |
Florida Blue Setting Facility Modifier None Typical Low $660.69 Median $1,318.26 Typical High $16,982.44 | Facility | None | $660.69 | $1,318.26 | $16,982.44 |
Florida Blue Setting Professional Modifier None Typical Low $346.74 Median $758.58 Typical High $912.01 | Professional | None | $346.74 | $758.58 | $912.01 |
Molina Setting Professional Modifier None Typical Low $60.26 Median $575.44 Typical High $977.24 | Professional | None | $60.26 | $575.44 | $977.24 |
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 $562.34 Median $724.44 Typical High $1,412.54 | Professional | None | $562.34 | $724.44 | $1,412.54 |
Wellpoint Setting Professional Modifier None Typical Low $630.96 Median $630.96 Typical High $831.76 | Professional | None | $630.96 | $630.96 | $831.76 |
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 $338.84 Median $380.19 Typical High $457.09 | Professional | 52 · Reduced service | $338.84 | $380.19 | $457.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $151.36 Typical High $181.97 | Professional | 53 · Discontinued | $134.90 | $151.36 | $181.97 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $575.44 Typical High $676.08 | Professional | 54 · Surgery only | $501.19 | $575.44 | $676.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $114.82 Typical High $134.90 | Professional | 55 · Aftercare only | $100.00 | $114.82 | $134.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $75.86 Typical High $91.20 | Professional | 56 · Pre-op care only | $67.61 | $75.86 | $91.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $467.74 Median $537.03 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $467.74 | $537.03 | $630.96 |
Where Florida sits
The same service costs 7.1 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
$692
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.