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 $851.14 Median $6,025.60 Typical High $12,882.50 | Facility | None | $851.14 | $6,025.60 | $12,882.50 |
Aetna Setting Professional Modifier None Typical Low $851.14 Median $912.01 Typical High $1,122.02 | Professional | None | $851.14 | $912.01 | $1,122.02 |
AvMed Setting Facility Modifier None Typical Low $724.44 Median $2,398.83 Typical High $9,772.37 | Facility | None | $724.44 | $2,398.83 | $9,772.37 |
AvMed Setting Professional Modifier None Typical Low $794.33 Median $1,047.13 Typical High $1,202.26 | Professional | None | $794.33 | $1,047.13 | $1,202.26 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $4,897.79 Typical High $9,332.54 | Facility | None | $707.95 | $4,897.79 | $9,332.54 |
Cigna Setting Professional Modifier None Typical Low $758.58 Median $794.33 Typical High $1,584.89 | Professional | None | $758.58 | $794.33 | $1,584.89 |
Florida Blue Setting Facility Modifier None Typical Low $1,318.26 Median $2,818.38 Typical High $16,982.44 | Facility | None | $1,318.26 | $2,818.38 | $16,982.44 |
Florida Blue Setting Professional Modifier None Typical Low $426.58 Median $912.01 Typical High $1,148.15 | Professional | None | $426.58 | $912.01 | $1,148.15 |
Molina Setting Professional Modifier None Typical Low $60.26 Median $630.96 Typical High $1,122.02 | Professional | None | $60.26 | $630.96 | $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 $1,737.80 | Professional | None | $691.83 | $891.25 | $1,737.80 |
Wellpoint Setting Professional Modifier None Typical Low $741.31 Median $741.31 Typical High $1,000.00 | Professional | None | $741.31 | $741.31 | $1,000.00 |
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 $416.87 Median $457.09 Typical High $549.54 | Professional | 52 · Reduced service | $416.87 | $457.09 | $549.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $181.97 Typical High $218.78 | Professional | 53 · Discontinued | $169.82 | $181.97 | $218.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $691.83 Typical High $831.76 | Professional | 54 · Surgery only | $630.96 | $691.83 | $831.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $138.04 Typical High $165.96 | Professional | 55 · Aftercare only | $125.89 | $138.04 | $165.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $91.20 Typical High $109.65 | Professional | 56 · Pre-op care only | $85.11 | $91.20 | $109.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $645.65 Typical High $776.25 | Professional | 78 · Unplanned return to OR | $588.84 | $645.65 | $776.25 |
Where Florida sits
The same service costs 7.9 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
$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.