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 $1,202.26 Median $6,025.60 Typical High $12,022.64 | Facility | None | $1,202.26 | $6,025.60 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $1,202.26 Median $1,230.27 Typical High $1,621.81 | Professional | None | $1,202.26 | $1,230.27 | $1,621.81 |
AvMed Setting Facility Modifier None Typical Low $1,023.29 Median $2,818.38 Typical High $11,748.98 | Facility | None | $1,023.29 | $2,818.38 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $1,071.52 Median $1,412.54 Typical High $1,621.81 | Professional | None | $1,071.52 | $1,412.54 | $1,621.81 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $2,951.21 Typical High $5,370.32 | Facility | None | $501.19 | $2,951.21 | $5,370.32 |
Cigna Setting Professional Modifier None Typical Low $1,000.00 Median $1,445.44 Typical High $2,630.27 | Professional | None | $1,000.00 | $1,445.44 | $2,630.27 |
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 $891.25 Median $954.99 Typical High $1,513.56 | Professional | None | $891.25 | $954.99 | $1,513.56 |
Molina Setting Professional Modifier None Typical Low $134.90 Median $977.24 Typical High $2,089.30 | Professional | None | $134.90 | $977.24 | $2,089.30 |
United Setting Facility Modifier None Typical Low $954.99 Median $2,344.23 Typical High $10,000.00 | Facility | None | $954.99 | $2,344.23 | $10,000.00 |
United Setting Professional Modifier None Typical Low $60.26 Median $1,513.56 Typical High $3,019.95 | Professional | None | $60.26 | $1,513.56 | $3,019.95 |
Wellpoint Setting Professional Modifier None Typical Low $977.24 Median $977.24 Typical High $1,288.25 | Professional | None | $977.24 | $977.24 | $1,288.25 |
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 $602.56 Median $616.60 Typical High $794.33 | Professional | 52 · Reduced service | $602.56 | $616.60 | $794.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $239.88 Median $245.47 Typical High $316.23 | Professional | 53 · Discontinued | $239.88 | $245.47 | $316.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $891.25 Median $912.01 Typical High $1,202.26 | Professional | 54 · Surgery only | $891.25 | $912.01 | $1,202.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $181.97 Typical High $239.88 | Professional | 55 · Aftercare only | $177.83 | $181.97 | $239.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $120.23 Median $123.03 Typical High $158.49 | Professional | 56 · Pre-op care only | $120.23 | $123.03 | $158.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $831.76 Median $851.14 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $831.76 | $851.14 | $1,122.02 |
Where Florida sits
The same service costs 6.5 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
$1,318
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.