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 $776.25 Median $6,025.60 Typical High $12,022.64 | Facility | None | $776.25 | $6,025.60 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $616.60 Median $691.83 Typical High $912.01 | Professional | None | $616.60 | $691.83 | $912.01 |
AvMed Setting Facility Modifier None Typical Low $630.96 Median $2,137.96 Typical High $9,772.37 | Facility | None | $630.96 | $2,137.96 | $9,772.37 |
AvMed Setting Professional Modifier None Typical Low $630.96 Median $794.33 Typical High $891.25 | Professional | None | $630.96 | $794.33 | $891.25 |
Cigna Setting Facility Modifier None Typical Low $616.60 Median $3,235.94 Typical High $5,370.32 | Facility | None | $616.60 | $3,235.94 | $5,370.32 |
Cigna Setting Professional Modifier None Typical Low $588.84 Median $794.33 Typical High $1,513.56 | Professional | None | $588.84 | $794.33 | $1,513.56 |
Florida Blue Setting Facility Modifier None Typical Low $1,737.80 Median $3,548.13 Typical High $16,982.44 | Facility | None | $1,737.80 | $3,548.13 | $16,982.44 |
Florida Blue Setting Professional Modifier None Typical Low $524.81 Median $562.34 Typical High $758.58 | Professional | None | $524.81 | $562.34 | $758.58 |
Molina Setting Professional Modifier None Typical Low $72.44 Median $562.34 Typical High $1,202.26 | Professional | None | $72.44 | $562.34 | $1,202.26 |
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 $60.26 Median $851.14 Typical High $1,621.81 | Professional | None | $60.26 | $851.14 | $1,621.81 |
Wellpoint Setting Professional Modifier None Typical Low $588.84 Median $588.84 Typical High $758.58 | Professional | None | $588.84 | $588.84 | $758.58 |
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 $309.03 Median $338.84 Typical High $457.09 | Professional | 52 · Reduced service | $309.03 | $338.84 | $457.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $138.04 Typical High $181.97 | Professional | 53 · Discontinued | $123.03 | $138.04 | $181.97 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $512.86 Typical High $676.08 | Professional | 54 · Surgery only | $467.74 | $512.86 | $676.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $102.33 Typical High $138.04 | Professional | 55 · Aftercare only | $93.33 | $102.33 | $138.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $69.18 Typical High $91.20 | Professional | 56 · Pre-op care only | $61.66 | $69.18 | $91.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $478.63 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $436.52 | $478.63 | $630.96 |
Where Florida sits
The same service costs 7.4 times more in Oklahoma 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· 46th of 51
$794
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.