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 $562.34 Median $616.60 Typical High $794.33 | Professional | None | $562.34 | $616.60 | $794.33 |
AvMed Setting Facility Modifier None Typical Low $588.84 Median $2,089.30 Typical High $9,772.37 | Facility | None | $588.84 | $2,089.30 | $9,772.37 |
AvMed Setting Professional Modifier None Typical Low $549.54 Median $724.44 Typical High $812.83 | Professional | None | $549.54 | $724.44 | $812.83 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $1,905.46 Typical High $2,884.03 | Facility | None | $501.19 | $1,905.46 | $2,884.03 |
Cigna Setting Professional Modifier None Typical Low $512.86 Median $549.54 Typical High $1,096.48 | Professional | None | $512.86 | $549.54 | $1,096.48 |
Florida Blue Setting Facility Modifier None Typical Low $1,230.27 Median $2,630.27 Typical High $16,982.44 | Facility | None | $1,230.27 | $2,630.27 | $16,982.44 |
Florida Blue Setting Professional Modifier None Typical Low $288.40 Median $630.96 Typical High $794.33 | Professional | None | $288.40 | $630.96 | $794.33 |
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 $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 $478.63 Median $616.60 Typical High $1,202.26 | Professional | None | $478.63 | $616.60 | $1,202.26 |
Wellpoint Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $691.83 | Professional | None | $524.81 | $524.81 | $691.83 |
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 $281.84 Median $309.03 Typical High $380.19 | Professional | 52 · Reduced service | $281.84 | $309.03 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $114.82 Median $125.89 Typical High $151.36 | Professional | 53 · Discontinued | $114.82 | $125.89 | $151.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $467.74 Typical High $562.34 | Professional | 54 · Surgery only | $426.58 | $467.74 | $562.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $93.33 Typical High $112.20 | Professional | 55 · Aftercare only | $85.11 | $93.33 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $61.66 Typical High $75.86 | Professional | 56 · Pre-op care only | $56.23 | $61.66 | $75.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $436.52 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $398.11 | $436.52 | $524.81 |
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· 47th of 51
$589
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.