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 $724.44 Median $6,456.54 Typical High $12,022.64 | Facility | None | $724.44 | $6,456.54 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $707.95 Median $724.44 Typical High $977.24 | Professional | None | $707.95 | $724.44 | $977.24 |
AvMed Setting Facility Modifier None Typical Low $691.83 Median $3,630.78 Typical High $13,182.57 | Facility | None | $691.83 | $3,630.78 | $13,182.57 |
AvMed Setting Professional Modifier None Typical Low $691.83 Median $851.14 Typical High $933.25 | Professional | None | $691.83 | $851.14 | $933.25 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $549.54 Typical High $19,952.62 | Facility | None | $398.11 | $549.54 | $19,952.62 |
Cigna Setting Professional Modifier None Typical Low $562.34 Median $851.14 Typical High $1,659.59 | Professional | None | $562.34 | $851.14 | $1,659.59 |
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 $575.44 Median $602.56 Typical High $954.99 | Professional | None | $575.44 | $602.56 | $954.99 |
Molina Setting Professional Modifier None Typical Low $69.18 Median $724.44 Typical High $1,047.13 | Professional | None | $69.18 | $724.44 | $1,047.13 |
United Setting Facility Modifier None Typical Low $371.54 Median $851.14 Typical High $7,244.36 | Facility | None | $371.54 | $851.14 | $7,244.36 |
United Setting Professional Modifier None Typical Low $54.95 Median $912.01 Typical High $2,041.74 | Professional | None | $54.95 | $912.01 | $2,041.74 |
Wellpoint Setting Professional Modifier None Typical Low $602.56 Median $602.56 Typical High $831.76 | Professional | None | $602.56 | $602.56 | $831.76 |
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 $354.81 Median $363.08 Typical High $478.63 | Professional | 52 · Reduced service | $354.81 | $363.08 | $478.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $141.25 Median $144.54 Typical High $190.55 | Professional | 53 · Discontinued | $141.25 | $144.54 | $190.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $549.54 Typical High $707.95 | Professional | 54 · Surgery only | $524.81 | $549.54 | $707.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $109.65 Typical High $141.25 | Professional | 55 · Aftercare only | $104.71 | $109.65 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $72.44 Typical High $95.50 | Professional | 56 · Pre-op care only | $70.79 | $72.44 | $95.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $512.86 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $489.78 | $512.86 | $660.69 |
Where Florida sits
The same service costs 4.6 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
$813
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.