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 $12,022.64 | Facility | None | $776.25 | $5,495.41 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $891.25 Median $1,047.13 Typical High $1,202.26 | Professional | None | $891.25 | $1,047.13 | $1,202.26 |
AvMed Setting Facility Modifier None Typical Low $794.33 Median $2,137.96 Typical High $11,748.98 | Facility | None | $794.33 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $812.83 Median $1,071.52 Typical High $1,230.27 | Professional | None | $812.83 | $1,071.52 | $1,230.27 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $1,905.46 Typical High $3,162.28 | Facility | None | $501.19 | $1,905.46 | $3,162.28 |
Cigna Setting Professional Modifier None Typical Low $707.95 Median $1,071.52 Typical High $2,238.72 | Professional | None | $707.95 | $1,071.52 | $2,238.72 |
Florida Blue Setting Facility Modifier None Typical Low $1,230.27 Median $2,691.53 Typical High $11,748.98 | Facility | None | $1,230.27 | $2,691.53 | $11,748.98 |
Florida Blue Setting Professional Modifier None Typical Low $660.69 Median $707.95 Typical High $1,096.48 | Professional | None | $660.69 | $707.95 | $1,096.48 |
Molina Setting Professional Modifier None Typical Low $56.23 Median $851.14 Typical High $1,202.26 | Professional | None | $56.23 | $851.14 | $1,202.26 |
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 $54.95 Median $1,174.90 Typical High $2,754.23 | Professional | None | $54.95 | $1,174.90 | $2,754.23 |
Wellpoint Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $1,000.00 | Professional | None | $691.83 | $691.83 | $1,000.00 |
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 $446.68 Median $512.86 Typical High $588.84 | Professional | 52 · Reduced service | $446.68 | $512.86 | $588.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $208.93 Typical High $239.88 | Professional | 53 · Discontinued | $177.83 | $208.93 | $239.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $776.25 Typical High $891.25 | Professional | 54 · Surgery only | $676.08 | $776.25 | $891.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $154.88 Typical High $177.83 | Professional | 55 · Aftercare only | $134.90 | $154.88 | $177.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $102.33 Typical High $117.49 | Professional | 56 · Pre-op care only | $89.13 | $102.33 | $117.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $724.44 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $630.96 | $724.44 | $831.76 |
Where Florida sits
The same service costs 4.6 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· 41st of 51
$1,230
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.