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 $3,890.45 Typical High $12,022.64 | Facility | None | $776.25 | $3,890.45 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $977.24 Median $1,047.13 Typical High $1,348.96 | Professional | None | $977.24 | $1,047.13 | $1,348.96 |
AvMed Setting Facility Modifier None Typical Low $933.25 Median $2,137.96 Typical High $13,182.57 | Facility | None | $933.25 | $2,137.96 | $13,182.57 |
AvMed Setting Professional Modifier None Typical Low $1,000.00 Median $1,230.27 Typical High $1,412.54 | Professional | None | $1,000.00 | $1,230.27 | $1,412.54 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $501.19 Typical High $2,691.53 | Facility | None | $398.11 | $501.19 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $831.76 Median $1,148.15 Typical High $2,344.23 | Professional | None | $831.76 | $1,148.15 | $2,344.23 |
Florida Blue Setting Facility Modifier None Typical Low $10,471.29 Median $22,387.21 Typical High $33,884.42 | Facility | None | $10,471.29 | $22,387.21 | $33,884.42 |
Florida Blue Setting Professional Modifier None Typical Low $812.83 Median $870.96 Typical High $1,230.27 | Professional | None | $812.83 | $870.96 | $1,230.27 |
Molina Setting Professional Modifier None Typical Low $109.65 Median $870.96 Typical High $1,819.70 | Professional | None | $109.65 | $870.96 | $1,819.70 |
United Setting Facility Modifier None Typical Low $371.54 Median $954.99 Typical High $7,585.78 | Facility | None | $371.54 | $954.99 | $7,585.78 |
United Setting Professional Modifier None Typical Low $60.26 Median $1,258.93 Typical High $2,454.71 | Professional | None | $60.26 | $1,258.93 | $2,454.71 |
Wellpoint Setting Professional Modifier None Typical Low $870.96 Median $870.96 Typical High $1,174.90 | Professional | None | $870.96 | $870.96 | $1,174.90 |
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 $489.78 Median $524.81 Typical High $676.08 | Professional | 52 · Reduced service | $489.78 | $524.81 | $676.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $208.93 Typical High $269.15 | Professional | 53 · Discontinued | $199.53 | $208.93 | $269.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $776.25 Typical High $1,000.00 | Professional | 54 · Surgery only | $741.31 | $776.25 | $1,000.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $154.88 Typical High $199.53 | Professional | 55 · Aftercare only | $147.91 | $154.88 | $199.53 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $104.71 Typical High $134.90 | Professional | 56 · Pre-op care only | $97.72 | $104.71 | $134.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $691.83 Median $724.44 Typical High $933.25 | Professional | 78 · Unplanned return to OR | $691.83 | $724.44 | $933.25 |
Where Florida sits
The same service costs 6.8 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
$1,000
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.