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 $5,495.41 Typical High $12,302.69 | Facility | None | $776.25 | $5,495.41 | $12,302.69 |
Aetna Setting Professional Modifier None Typical Low $954.99 Median $1,122.02 Typical High $1,258.93 | Professional | None | $954.99 | $1,122.02 | $1,258.93 |
AvMed Setting Facility Modifier None Typical Low $812.83 Median $2,951.21 Typical High $11,748.98 | Facility | None | $812.83 | $2,951.21 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $851.14 Median $1,122.02 Typical High $1,348.96 | Professional | None | $851.14 | $1,122.02 | $1,348.96 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $3,090.30 Typical High $5,623.41 | Facility | None | $501.19 | $3,090.30 | $5,623.41 |
Cigna Setting Professional Modifier None Typical Low $758.58 Median $1,148.15 Typical High $2,344.23 | Professional | None | $758.58 | $1,148.15 | $2,344.23 |
Florida Blue Setting Facility Modifier None Typical Low $2,630.27 Median $5,495.41 Typical High $16,982.44 | Facility | None | $2,630.27 | $5,495.41 | $16,982.44 |
Florida Blue Setting Professional Modifier None Typical Low $707.95 Median $741.31 Typical High $1,148.15 | Professional | None | $707.95 | $741.31 | $1,148.15 |
Molina Setting Professional Modifier None Typical Low $56.23 Median $912.01 Typical High $1,288.25 | Professional | None | $56.23 | $912.01 | $1,288.25 |
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 $54.95 Median $1,230.27 Typical High $3,090.30 | Professional | None | $54.95 | $1,230.27 | $3,090.30 |
Wellpoint Setting Professional Modifier None Typical Low $724.44 Median $724.44 Typical High $1,071.52 | Professional | None | $724.44 | $724.44 | $1,071.52 |
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 $478.63 Median $549.54 Typical High $630.96 | Professional | 52 · Reduced service | $478.63 | $549.54 | $630.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $190.55 Median $218.78 Typical High $251.19 | Professional | 53 · Discontinued | $190.55 | $218.78 | $251.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $831.76 Typical High $954.99 | Professional | 54 · Surgery only | $707.95 | $831.76 | $954.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $165.96 Typical High $190.55 | Professional | 55 · Aftercare only | $141.25 | $165.96 | $190.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $109.65 Typical High $125.89 | Professional | 56 · Pre-op care only | $95.50 | $109.65 | $125.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $660.69 Median $776.25 Typical High $891.25 | Professional | 78 · Unplanned return to OR | $660.69 | $776.25 | $891.25 |
Where Florida sits
The same service costs 5.1 times more in Wisconsin 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· 33rd of 51
$1,585
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.