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 $562.34 Median $3,715.35 Typical High $11,481.54 | Facility | None | $562.34 | $3,715.35 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $457.09 Median $562.34 Typical High $691.83 | Professional | None | $457.09 | $562.34 | $691.83 |
AvMed Setting Facility Modifier None Typical Low $489.78 Median $1,584.89 Typical High $9,549.93 | Facility | None | $489.78 | $1,584.89 | $9,549.93 |
AvMed Setting Professional Modifier None Typical Low $457.09 Median $616.60 Typical High $707.95 | Professional | None | $457.09 | $616.60 | $707.95 |
Cigna Setting Facility Modifier None Typical Low $436.52 Median $1,023.29 Typical High $2,187.76 | Facility | None | $436.52 | $1,023.29 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $457.09 Median $478.63 Typical High $933.25 | Professional | None | $457.09 | $478.63 | $933.25 |
Florida Blue Setting Facility Modifier None Typical Low $616.60 Median $1,348.96 Typical High $6,309.57 | Facility | None | $616.60 | $1,348.96 | $6,309.57 |
Florida Blue Setting Professional Modifier None Typical Low $239.88 Median $524.81 Typical High $676.08 | Professional | None | $239.88 | $524.81 | $676.08 |
Molina Setting Professional Modifier None Typical Low $60.26 Median $398.11 Typical High $724.44 | Professional | None | $60.26 | $398.11 | $724.44 |
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 $363.08 Median $512.86 Typical High $1,047.13 | Professional | None | $363.08 | $512.86 | $1,047.13 |
Wellpoint Setting Professional Modifier None Typical Low $436.52 Median $436.52 Typical High $616.60 | Professional | None | $436.52 | $436.52 | $616.60 |
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 $223.87 Median $281.84 Typical High $338.84 | Professional | 52 · Reduced service | $223.87 | $281.84 | $338.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $112.20 Typical High $134.90 | Professional | 53 · Discontinued | $91.20 | $112.20 | $134.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $338.84 Median $416.87 Typical High $501.19 | Professional | 54 · Surgery only | $338.84 | $416.87 | $501.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $83.18 Typical High $100.00 | Professional | 55 · Aftercare only | $67.61 | $83.18 | $100.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $56.23 Typical High $67.61 | Professional | 56 · Pre-op care only | $45.71 | $56.23 | $67.61 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $316.23 Median $389.05 Typical High $467.74 | Professional | 78 · Unplanned return to OR | $316.23 | $389.05 | $467.74 |
Where Florida sits
The same service costs 7.4 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
$513
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.