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 $630.96 Median $4,786.30 Typical High $11,748.98 | Facility | None | $630.96 | $4,786.30 | $11,748.98 |
Aetna Setting Professional Modifier None Typical Low $512.86 Median $562.34 Typical High $758.58 | Professional | None | $512.86 | $562.34 | $758.58 |
AvMed Setting Facility Modifier None Typical Low $575.44 Median $2,089.30 Typical High $9,772.37 | Facility | None | $575.44 | $2,089.30 | $9,772.37 |
AvMed Setting Professional Modifier None Typical Low $537.03 Median $676.08 Typical High $776.25 | Professional | None | $537.03 | $676.08 | $776.25 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $2,344.23 Typical High $3,801.89 | Facility | None | $501.19 | $2,344.23 | $3,801.89 |
Cigna Setting Professional Modifier None Typical Low $501.19 Median $537.03 Typical High $1,047.13 | Professional | None | $501.19 | $537.03 | $1,047.13 |
Florida Blue Setting Facility Modifier None Typical Low $1,288.25 Median $2,630.27 Typical High $16,982.44 | Facility | None | $1,288.25 | $2,630.27 | $16,982.44 |
Florida Blue Setting Professional Modifier None Typical Low $263.03 Median $588.84 Typical High $758.58 | Professional | None | $263.03 | $588.84 | $758.58 |
Molina Setting Professional Modifier None Typical Low $60.26 Median $416.87 Typical High $794.33 | Professional | None | $60.26 | $416.87 | $794.33 |
United Setting Facility Modifier None Typical Low $794.33 Median $1,778.28 Typical High $7,585.78 | Facility | None | $794.33 | $1,778.28 | $7,585.78 |
United Setting Professional Modifier None Typical Low $436.52 Median $575.44 Typical High $1,148.15 | Professional | None | $436.52 | $575.44 | $1,148.15 |
Wellpoint Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $676.08 | Professional | None | $512.86 | $512.86 | $676.08 |
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 $281.84 Typical High $371.54 | Professional | 52 · Reduced service | $257.04 | $281.84 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $112.20 Typical High $147.91 | Professional | 53 · Discontinued | $102.33 | $112.20 | $147.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $416.87 Typical High $549.54 | Professional | 54 · Surgery only | $389.05 | $416.87 | $549.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $83.18 Typical High $109.65 | Professional | 55 · Aftercare only | $77.62 | $83.18 | $109.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $56.23 Typical High $74.13 | Professional | 56 · Pre-op care only | $51.29 | $56.23 | $74.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $363.08 Median $389.05 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $363.08 | $389.05 | $512.86 |
Where Florida sits
The same service costs 8.5 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
$562
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.