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 $758.58 Median $6,025.60 Typical High $13,182.57 | Facility | None | $758.58 | $6,025.60 | $13,182.57 |
Aetna Setting Professional Modifier None Typical Low $489.78 Median $645.65 Typical High $794.33 | Professional | None | $489.78 | $645.65 | $794.33 |
AvMed Setting Facility Modifier None Typical Low $588.84 Median $2,137.96 Typical High $11,748.98 | Facility | None | $588.84 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $562.34 Median $707.95 Typical High $851.14 | Professional | None | $562.34 | $707.95 | $851.14 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $2,398.83 Typical High $3,715.35 | Facility | None | $512.86 | $2,398.83 | $3,715.35 |
Cigna Setting Professional Modifier None Typical Low $524.81 Median $549.54 Typical High $1,071.52 | Professional | None | $524.81 | $549.54 | $1,071.52 |
Florida Blue Setting Facility Modifier None Typical Low $1,258.93 Median $2,630.27 Typical High $16,982.44 | Facility | None | $1,258.93 | $2,630.27 | $16,982.44 |
Florida Blue Setting Professional Modifier None Typical Low $245.47 Median $562.34 Typical High $758.58 | Professional | None | $245.47 | $562.34 | $758.58 |
Molina Setting Professional Modifier None Typical Low $60.26 Median $446.68 Typical High $851.14 | Professional | None | $60.26 | $446.68 | $851.14 |
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 $478.63 Median $602.56 Typical High $1,174.90 | Professional | None | $478.63 | $602.56 | $1,174.90 |
Wellpoint Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $691.83 | Professional | None | $524.81 | $524.81 | $691.83 |
7 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 $245.47 Median $323.59 Typical High $380.19 | Professional | 52 · Reduced service | $245.47 | $323.59 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $128.82 Typical High $151.36 | Professional | 53 · Discontinued | $97.72 | $128.82 | $151.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $478.63 Typical High $575.44 | Professional | 54 · Surgery only | $371.54 | $478.63 | $575.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $95.50 Typical High $114.82 | Professional | 55 · Aftercare only | $74.13 | $95.50 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $64.57 Typical High $75.86 | Professional | 56 · Pre-op care only | $48.98 | $64.57 | $75.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $346.74 Median $446.68 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $346.74 | $446.68 | $537.03 |
Ambetter Setting Professional Modifier 50 · Both sides Typical Low $1,819.70 Median $1,819.70 Typical High $1,819.70 | Professional | 50 · Both sides | $1,819.70 | $1,819.70 | $1,819.70 |
Where Florida sits
The same service costs 7.6 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· 48th of 51
$603
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.