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 $660.69 Median $5,495.41 Typical High $12,302.69 | Facility | None | $660.69 | $5,495.41 | $12,302.69 |
Aetna Setting Professional Modifier None Typical Low $512.86 Median $562.34 Typical High $741.31 | Professional | None | $512.86 | $562.34 | $741.31 |
AvMed Setting Facility Modifier None Typical Low $524.81 Median $2,089.30 Typical High $9,772.37 | Facility | None | $524.81 | $2,089.30 | $9,772.37 |
AvMed Setting Professional Modifier None Typical Low $501.19 Median $645.65 Typical High $724.44 | Professional | None | $501.19 | $645.65 | $724.44 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $2,089.30 Typical High $11,481.54 | Facility | None | $512.86 | $2,089.30 | $11,481.54 |
Cigna Setting Professional Modifier None Typical Low $457.09 Median $489.78 Typical High $977.24 | Professional | None | $457.09 | $489.78 | $977.24 |
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 $263.03 Median $575.44 Typical High $676.08 | Professional | None | $263.03 | $575.44 | $676.08 |
Molina Setting Professional Modifier None Typical Low $60.26 Median $398.11 Typical High $724.44 | Professional | None | $60.26 | $398.11 | $724.44 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $2,754.23 Typical High $10,000.00 | Facility | None | $1,000.00 | $2,754.23 | $10,000.00 |
United Setting Professional Modifier None Typical Low $426.58 Median $549.54 Typical High $1,071.52 | Professional | None | $426.58 | $549.54 | $1,071.52 |
Wellpoint Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $616.60 | Professional | None | $467.74 | $467.74 | $616.60 |
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 $257.04 Median $281.84 Typical High $338.84 | Professional | 52 · Reduced service | $257.04 | $281.84 | $338.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $112.20 Typical High $134.90 | Professional | 53 · Discontinued | $102.33 | $112.20 | $134.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $426.58 Typical High $512.86 | Professional | 54 · Surgery only | $380.19 | $426.58 | $512.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $85.11 Typical High $102.33 | Professional | 55 · Aftercare only | $75.86 | $85.11 | $102.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $56.23 Typical High $67.61 | Professional | 56 · Pre-op care only | $51.29 | $56.23 | $67.61 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $354.81 Median $398.11 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $354.81 | $398.11 | $478.63 |
Where Florida sits
The same service costs 7.4 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
$537
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.