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 $630.96 Median $4,365.16 Typical High $11,748.98 | Facility | None | $630.96 | $4,365.16 | $11,748.98 |
Aetna Setting Professional Modifier None Typical Low $257.04 Median $891.25 Typical High $1,584.89 | Professional | None | $257.04 | $891.25 | $1,584.89 |
AvMed Setting Facility Modifier None Typical Low $562.34 Median $1,949.84 Typical High $9,772.37 | Facility | None | $562.34 | $1,949.84 | $9,772.37 |
AvMed Setting Professional Modifier None Typical Low $331.13 Median $1,174.90 Typical High $1,621.81 | Professional | None | $331.13 | $1,174.90 | $1,621.81 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $1,949.84 Typical High $17,378.01 | Facility | None | $512.86 | $1,949.84 | $17,378.01 |
Cigna Setting Professional Modifier None Typical Low $257.04 Median $831.76 Typical High $2,137.96 | Professional | None | $257.04 | $831.76 | $2,137.96 |
Florida Blue Setting Facility Modifier None Typical Low $1,000.00 Median $2,187.76 Typical High $11,748.98 | Facility | None | $1,000.00 | $2,187.76 | $11,748.98 |
Florida Blue Setting Professional Modifier None Typical Low $1,071.52 Median $1,148.15 Typical High $1,778.28 | Professional | None | $1,071.52 | $1,148.15 | $1,778.28 |
Molina Setting Professional Modifier None Typical Low $134.90 Median $1,348.96 Typical High $1,995.26 | Professional | None | $134.90 | $1,348.96 | $1,995.26 |
United Setting Facility Modifier None Typical Low $954.99 Median $2,344.23 Typical High $11,220.18 | Facility | None | $954.99 | $2,344.23 | $11,220.18 |
United Setting Professional Modifier None Typical Low $251.19 Median $851.14 Typical High $2,344.23 | Professional | None | $251.19 | $851.14 | $2,344.23 |
Wellpoint Setting Professional Modifier None Typical Low $245.47 Median $407.38 Typical High $407.38 | Professional | None | $245.47 | $407.38 | $407.38 |
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 $128.82 Median $446.68 Typical High $758.58 | Professional | 52 · Reduced service | $128.82 | $446.68 | $758.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $51.29 Median $177.83 Typical High $302.00 | Professional | 53 · Discontinued | $51.29 | $177.83 | $302.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $194.98 Median $660.69 Typical High $1,148.15 | Professional | 54 · Surgery only | $194.98 | $660.69 | $1,148.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $131.83 Typical High $229.09 | Professional | 55 · Aftercare only | $38.90 | $131.83 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $89.13 Typical High $151.36 | Professional | 56 · Pre-op care only | $25.70 | $89.13 | $151.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $181.97 Median $616.60 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $181.97 | $616.60 | $1,071.52 |
Where Florida sits
The same service costs 5.8 times more in Alaska than in Nebraska. 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· 32nd of 51
$1,413
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.