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 $13,182.57 | Facility | None | $851.14 | $6,025.60 | $13,182.57 |
Aetna Setting Professional Modifier None Typical Low $1,148.15 Median $1,258.93 Typical High $1,513.56 | Professional | None | $1,148.15 | $1,258.93 | $1,513.56 |
AvMed Setting Facility Modifier None Typical Low $1,047.13 Median $4,168.69 Typical High $11,748.98 | Facility | None | $1,047.13 | $4,168.69 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $1,047.13 Median $1,380.38 Typical High $1,584.89 | Professional | None | $1,047.13 | $1,380.38 | $1,584.89 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $4,365.16 Typical High $8,317.64 | Facility | None | $512.86 | $4,365.16 | $8,317.64 |
Cigna Setting Professional Modifier None Typical Low $1,023.29 Median $1,071.52 Typical High $2,187.76 | Professional | None | $1,023.29 | $1,071.52 | $2,187.76 |
Florida Blue Setting Facility Modifier None Typical Low $2,818.38 Median $5,495.41 Typical High $16,982.44 | Facility | None | $2,818.38 | $5,495.41 | $16,982.44 |
Florida Blue Setting Professional Modifier None Typical Low $588.84 Median $1,230.27 Typical High $1,548.82 | Professional | None | $588.84 | $1,230.27 | $1,548.82 |
Molina Setting Professional Modifier None Typical Low $91.20 Median $831.76 Typical High $1,513.56 | Professional | None | $91.20 | $831.76 | $1,513.56 |
United Setting Facility Modifier None Typical Low $1,584.89 Median $4,073.80 Typical High $15,488.17 | Facility | None | $1,584.89 | $4,073.80 | $15,488.17 |
United Setting Professional Modifier None Typical Low $933.25 Median $1,202.26 Typical High $2,398.83 | Professional | None | $933.25 | $1,202.26 | $2,398.83 |
Wellpoint Setting Professional Modifier None Typical Low $977.24 Median $977.24 Typical High $1,318.26 | Professional | None | $977.24 | $977.24 | $1,318.26 |
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 $575.44 Median $630.96 Typical High $758.58 | Professional | 52 · Reduced service | $575.44 | $630.96 | $758.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $229.09 Median $251.19 Typical High $302.00 | Professional | 53 · Discontinued | $229.09 | $251.19 | $302.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $851.14 Median $954.99 Typical High $1,122.02 | Professional | 54 · Surgery only | $851.14 | $954.99 | $1,122.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $190.55 Typical High $223.87 | Professional | 55 · Aftercare only | $173.78 | $190.55 | $223.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $125.89 Typical High $151.36 | Professional | 56 · Pre-op care only | $114.82 | $125.89 | $151.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $794.33 Median $891.25 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $794.33 | $891.25 | $1,047.13 |
Where Florida sits
The same service costs 18.6 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
$1,148
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.