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 $549.54 Median $4,073.80 Typical High $11,481.54 | Facility | None | $549.54 | $4,073.80 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $302.00 Median $338.84 Typical High $616.60 | Professional | None | $302.00 | $338.84 | $616.60 |
AvMed Setting Facility Modifier None Typical Low $446.68 Median $1,995.26 Typical High $9,549.93 | Facility | None | $446.68 | $1,995.26 | $9,549.93 |
AvMed Setting Professional Modifier None Typical Low $346.74 Median $416.87 Typical High $489.78 | Professional | None | $346.74 | $416.87 | $489.78 |
Cigna Setting Facility Modifier None Typical Low $436.52 Median $2,754.23 Typical High $5,128.61 | Facility | None | $436.52 | $2,754.23 | $5,128.61 |
Cigna Setting Professional Modifier None Typical Low $302.00 Median $426.58 Typical High $812.83 | Professional | None | $302.00 | $426.58 | $812.83 |
Florida Blue Setting Facility Modifier None Typical Low $977.24 Median $1,949.84 Typical High $16,982.44 | Facility | None | $977.24 | $1,949.84 | $16,982.44 |
Florida Blue Setting Professional Modifier None Typical Low $295.12 Median $316.23 Typical High $407.38 | Professional | None | $295.12 | $316.23 | $407.38 |
Molina Setting Professional Modifier None Typical Low $281.84 Median $389.05 Typical High $537.03 | Professional | None | $281.84 | $389.05 | $537.03 |
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 $457.09 Typical High $1,023.29 | Professional | None | $54.95 | $457.09 | $1,023.29 |
Wellpoint Setting Professional Modifier None Typical Low $316.23 Median $316.23 Typical High $436.52 | Professional | None | $316.23 | $316.23 | $436.52 |
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 $151.36 Median $158.49 Typical High $245.47 | Professional | 52 · Reduced service | $151.36 | $158.49 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $60.26 Median $63.10 Typical High $97.72 | Professional | 53 · Discontinued | $60.26 | $63.10 | $97.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $229.09 Median $239.88 Typical High $371.54 | Professional | 54 · Surgery only | $229.09 | $239.88 | $371.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $45.71 Median $47.86 Typical High $74.13 | Professional | 55 · Aftercare only | $45.71 | $47.86 | $74.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $31.62 Typical High $48.98 | Professional | 56 · Pre-op care only | $30.20 | $31.62 | $48.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $213.80 Median $223.87 Typical High $346.74 | Professional | 78 · Unplanned return to OR | $213.80 | $223.87 | $346.74 |
Where Florida sits
The same service costs 5.4 times more in Alaska than in New York. 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· 11th of 51
$1,047
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.