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 $12,589.25 | Facility | None | $660.69 | $5,495.41 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $407.38 Median $457.09 Typical High $588.84 | Professional | None | $407.38 | $457.09 | $588.84 |
AvMed Setting Facility Modifier None Typical Low $501.19 Median $2,089.30 Typical High $9,772.37 | Facility | None | $501.19 | $2,089.30 | $9,772.37 |
AvMed Setting Professional Modifier None Typical Low $426.58 Median $537.03 Typical High $602.56 | Professional | None | $426.58 | $537.03 | $602.56 |
Cigna Setting Facility Modifier None Typical Low $537.03 Median $2,089.30 Typical High $11,481.54 | Facility | None | $537.03 | $2,089.30 | $11,481.54 |
Cigna Setting Professional Modifier None Typical Low $389.05 Median $416.87 Typical High $812.83 | Professional | None | $389.05 | $416.87 | $812.83 |
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 $190.55 Median $457.09 Typical High $575.44 | Professional | None | $190.55 | $457.09 | $575.44 |
Molina Setting Professional Modifier None Typical Low $60.26 Median $323.59 Typical High $602.56 | Professional | None | $60.26 | $323.59 | $602.56 |
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 $354.81 Median $457.09 Typical High $891.25 | Professional | None | $354.81 | $457.09 | $891.25 |
Wellpoint Setting Professional Modifier None Typical Low $407.38 Median $407.38 Typical High $537.03 | Professional | None | $407.38 | $407.38 | $537.03 |
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 $204.17 Median $229.09 Typical High $288.40 | Professional | 52 · Reduced service | $204.17 | $229.09 | $288.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $91.20 Typical High $114.82 | Professional | 53 · Discontinued | $81.28 | $91.20 | $114.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $346.74 Typical High $426.58 | Professional | 54 · Surgery only | $309.03 | $346.74 | $426.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $69.18 Typical High $87.10 | Professional | 55 · Aftercare only | $61.66 | $69.18 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $45.71 Typical High $57.54 | Professional | 56 · Pre-op care only | $40.74 | $45.71 | $57.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $323.59 Typical High $398.11 | Professional | 78 · Unplanned return to OR | $288.40 | $323.59 | $398.11 |
Where Florida sits
The same service costs 7.9 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
$447
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.