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 $489.78 Median $3,801.89 Typical High $10,964.78 | Facility | None | $489.78 | $3,801.89 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $245.47 Median $371.54 Typical High $549.54 | Professional | None | $245.47 | $371.54 | $549.54 |
AvMed Setting Facility Modifier None Typical Low $489.78 Median $1,479.11 Typical High $9,549.93 | Facility | None | $489.78 | $1,479.11 | $9,549.93 |
AvMed Setting Professional Modifier None Typical Low $323.59 Median $467.74 Typical High $660.69 | Professional | None | $323.59 | $467.74 | $660.69 |
Cigna Setting Facility Modifier None Typical Low $436.52 Median $1,348.96 Typical High $2,187.76 | Facility | None | $436.52 | $1,348.96 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $251.19 Median $407.38 Typical High $676.08 | Professional | None | $251.19 | $407.38 | $676.08 |
Florida Blue Setting Facility Modifier None Typical Low $977.24 Median $2,187.76 Typical High $6,309.57 | Facility | None | $977.24 | $2,187.76 | $6,309.57 |
Florida Blue Setting Professional Modifier None Typical Low $190.55 Median $436.52 Typical High $676.08 | Professional | None | $190.55 | $436.52 | $676.08 |
Molina Setting Professional Modifier None Typical Low $63.10 Median $371.54 Typical High $741.31 | Professional | None | $63.10 | $371.54 | $741.31 |
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 $234.42 Median $398.11 Typical High $776.25 | Professional | None | $234.42 | $398.11 | $776.25 |
Wellpoint Setting Professional Modifier None Typical Low $275.42 Median $501.19 Typical High $501.19 | Professional | None | $275.42 | $501.19 | $501.19 |
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 $123.03 Median $186.21 Typical High $275.42 | Professional | 52 · Reduced service | $123.03 | $186.21 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $74.13 Typical High $109.65 | Professional | 53 · Discontinued | $48.98 | $74.13 | $109.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $181.97 Median $275.42 Typical High $407.38 | Professional | 54 · Surgery only | $181.97 | $275.42 | $407.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $54.95 Typical High $81.28 | Professional | 55 · Aftercare only | $36.31 | $54.95 | $81.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $37.15 Typical High $54.95 | Professional | 56 · Pre-op care only | $24.55 | $37.15 | $54.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $169.82 Median $257.04 Typical High $380.19 | Professional | 78 · Unplanned return to OR | $169.82 | $257.04 | $380.19 |
Where Florida sits
The same service costs 4.7 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· 44th of 51
$437
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.