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 $794.33 Median $6,025.60 Typical High $13,182.57 | Facility | None | $794.33 | $6,025.60 | $13,182.57 |
Aetna Setting Professional Modifier None Typical Low $794.33 Median $812.83 Typical High $1,122.02 | Professional | None | $794.33 | $812.83 | $1,122.02 |
AvMed Setting Facility Modifier None Typical Low $794.33 Median $2,137.96 Typical High $11,748.98 | Facility | None | $794.33 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $794.33 Median $1,047.13 Typical High $1,174.90 | Professional | None | $794.33 | $1,047.13 | $1,174.90 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $1,905.46 Typical High $3,235.94 | Facility | None | $512.86 | $1,905.46 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $758.58 Median $794.33 Typical High $1,548.82 | Professional | None | $758.58 | $794.33 | $1,548.82 |
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 $416.87 Median $912.01 Typical High $1,096.48 | Professional | None | $416.87 | $912.01 | $1,096.48 |
Molina Setting Professional Modifier None Typical Low $60.26 Median $630.96 Typical High $1,122.02 | Professional | None | $60.26 | $630.96 | $1,122.02 |
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 $676.08 Median $891.25 Typical High $1,737.80 | Professional | None | $676.08 | $891.25 | $1,737.80 |
Wellpoint Setting Professional Modifier None Typical Low $741.31 Median $741.31 Typical High $1,000.00 | Professional | None | $741.31 | $741.31 | $1,000.00 |
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 $398.11 Median $407.38 Typical High $549.54 | Professional | 52 · Reduced service | $398.11 | $407.38 | $549.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $162.18 Typical High $218.78 | Professional | 53 · Discontinued | $158.49 | $162.18 | $218.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $616.60 Typical High $831.76 | Professional | 54 · Surgery only | $588.84 | $616.60 | $831.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $123.03 Typical High $165.96 | Professional | 55 · Aftercare only | $117.49 | $123.03 | $165.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $81.28 Typical High $109.65 | Professional | 56 · Pre-op care only | $79.43 | $81.28 | $109.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $575.44 Typical High $776.25 | Professional | 78 · Unplanned return to OR | $549.54 | $575.44 | $776.25 |
Where Florida sits
The same service costs 18.2 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
$813
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.