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 $12,882.50 | Facility | None | $851.14 | $6,025.60 | $12,882.50 |
Aetna Setting Professional Modifier None Typical Low $1,000.00 Median $1,071.52 Typical High $1,288.25 | Professional | None | $1,000.00 | $1,071.52 | $1,288.25 |
AvMed Setting Facility Modifier None Typical Low $891.25 Median $3,548.13 Typical High $11,748.98 | Facility | None | $891.25 | $3,548.13 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $891.25 Median $1,202.26 Typical High $1,412.54 | Professional | None | $891.25 | $1,202.26 | $1,412.54 |
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 $870.96 Median $912.01 Typical High $1,862.09 | Professional | None | $870.96 | $912.01 | $1,862.09 |
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 $512.86 Median $1,071.52 Typical High $1,412.54 | Professional | None | $512.86 | $1,071.52 | $1,412.54 |
Molina Setting Professional Modifier None Typical Low $91.20 Median $707.95 Typical High $1,288.25 | Professional | None | $91.20 | $707.95 | $1,288.25 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $3,311.31 Typical High $12,589.25 | Facility | None | $1,230.27 | $3,311.31 | $12,589.25 |
United Setting Professional Modifier None Typical Low $812.83 Median $1,047.13 Typical High $2,041.74 | Professional | None | $812.83 | $1,047.13 | $2,041.74 |
Wellpoint Setting Professional Modifier None Typical Low $831.76 Median $831.76 Typical High $1,122.02 | Professional | None | $831.76 | $831.76 | $1,122.02 |
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 $501.19 Median $537.03 Typical High $645.65 | Professional | 52 · Reduced service | $501.19 | $537.03 | $645.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $213.80 Typical High $257.04 | Professional | 53 · Discontinued | $199.53 | $213.80 | $257.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $812.83 Typical High $954.99 | Professional | 54 · Surgery only | $758.58 | $812.83 | $954.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $162.18 Typical High $190.55 | Professional | 55 · Aftercare only | $151.36 | $162.18 | $190.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $107.15 Typical High $128.82 | Professional | 56 · Pre-op care only | $100.00 | $107.15 | $128.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $758.58 Typical High $891.25 | Professional | 78 · Unplanned return to OR | $707.95 | $758.58 | $891.25 |
Where Florida sits
The same service costs 8.7 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
$1,000
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.