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 $446.68 Median $512.86 Typical High $630.96 | Professional | None | $446.68 | $512.86 | $630.96 |
AvMed Setting Facility Modifier None Typical Low $512.86 Median $2,089.30 Typical High $9,772.37 | Facility | None | $512.86 | $2,089.30 | $9,772.37 |
AvMed Setting Professional Modifier None Typical Low $457.09 Median $562.34 Typical High $660.69 | Professional | None | $457.09 | $562.34 | $660.69 |
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 $416.87 Median $446.68 Typical High $870.96 | Professional | None | $416.87 | $446.68 | $870.96 |
Florida Blue Setting Facility Modifier None Typical Low $870.96 Median $1,737.80 Typical High $16,982.44 | Facility | None | $870.96 | $1,737.80 | $16,982.44 |
Florida Blue Setting Professional Modifier None Typical Low $229.09 Median $512.86 Typical High $616.60 | Professional | None | $229.09 | $512.86 | $616.60 |
Molina Setting Professional Modifier None Typical Low $60.26 Median $346.74 Typical High $676.08 | Professional | None | $60.26 | $346.74 | $676.08 |
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 $380.19 Median $489.78 Typical High $977.24 | Professional | None | $380.19 | $489.78 | $977.24 |
Wellpoint Setting Professional Modifier None Typical Low $426.58 Median $426.58 Typical High $562.34 | Professional | None | $426.58 | $426.58 | $562.34 |
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 $223.87 Median $257.04 Typical High $309.03 | Professional | 52 · Reduced service | $223.87 | $257.04 | $309.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $102.33 Typical High $123.03 | Professional | 53 · Discontinued | $89.13 | $102.33 | $123.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $338.84 Median $389.05 Typical High $467.74 | Professional | 54 · Surgery only | $338.84 | $389.05 | $467.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $77.62 Typical High $93.33 | Professional | 55 · Aftercare only | $67.61 | $77.62 | $93.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $51.29 Typical High $61.66 | Professional | 56 · Pre-op care only | $44.67 | $51.29 | $61.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $316.23 Median $363.08 Typical High $436.52 | Professional | 78 · Unplanned return to OR | $316.23 | $363.08 | $436.52 |
Where Florida sits
The same service costs 8.1 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
$490
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.