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 $912.01 Median $977.24 Typical High $1,230.27 | Professional | None | $912.01 | $977.24 | $1,230.27 |
AvMed Setting Facility Modifier None Typical Low $794.33 Median $2,951.21 Typical High $11,748.98 | Facility | None | $794.33 | $2,951.21 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $831.76 Median $1,071.52 Typical High $1,258.93 | Professional | None | $831.76 | $1,071.52 | $1,258.93 |
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 $724.44 Median $1,071.52 Typical High $2,187.76 | Professional | None | $724.44 | $1,071.52 | $2,187.76 |
Florida Blue Setting Facility Modifier None Typical Low $2,691.53 Median $5,888.44 Typical High $19,952.62 | Facility | None | $2,691.53 | $5,888.44 | $19,952.62 |
Florida Blue Setting Professional Modifier None Typical Low $691.83 Median $724.44 Typical High $1,096.48 | Professional | None | $691.83 | $724.44 | $1,096.48 |
Molina Setting Professional Modifier None Typical Low $56.23 Median $870.96 Typical High $1,258.93 | Professional | None | $56.23 | $870.96 | $1,258.93 |
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 $1,174.90 Typical High $2,691.53 | Professional | None | $54.95 | $1,174.90 | $2,691.53 |
Wellpoint Setting Professional Modifier None Typical Low $707.95 Median $707.95 Typical High $1,023.29 | Professional | None | $707.95 | $707.95 | $1,023.29 |
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 $457.09 Median $489.78 Typical High $602.56 | Professional | 52 · Reduced service | $457.09 | $489.78 | $602.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $181.97 Median $194.98 Typical High $245.47 | Professional | 53 · Discontinued | $181.97 | $194.98 | $245.47 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $741.31 Typical High $912.01 | Professional | 54 · Surgery only | $691.83 | $741.31 | $912.01 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $147.91 Typical High $181.97 | Professional | 55 · Aftercare only | $138.04 | $147.91 | $181.97 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $97.72 Typical High $123.03 | Professional | 56 · Pre-op care only | $91.20 | $97.72 | $123.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $691.83 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $645.65 | $691.83 | $851.14 |
Where Florida sits
The same service costs 5.0 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· 27th of 51
$1,622
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.