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 $6,025.60 Typical High $12,022.64 | Facility | None | $776.25 | $6,025.60 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $416.87 Median $457.09 Typical High $630.96 | Professional | None | $416.87 | $457.09 | $630.96 |
AvMed Setting Facility Modifier None Typical Low $524.81 Median $2,137.96 Typical High $9,772.37 | Facility | None | $524.81 | $2,137.96 | $9,772.37 |
AvMed Setting Professional Modifier None Typical Low $426.58 Median $512.86 Typical High $575.44 | Professional | None | $426.58 | $512.86 | $575.44 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $2,754.23 Typical High $17,378.01 | Facility | None | $630.96 | $2,754.23 | $17,378.01 |
Cigna Setting Professional Modifier None Typical Low $354.81 Median $501.19 Typical High $954.99 | Professional | None | $354.81 | $501.19 | $954.99 |
Florida Blue Setting Facility Modifier None Typical Low $1,513.56 Median $3,311.31 Typical High $11,748.98 | Facility | None | $1,513.56 | $3,311.31 | $11,748.98 |
Florida Blue Setting Professional Modifier None Typical Low $346.74 Median $371.54 Typical High $501.19 | Professional | None | $346.74 | $371.54 | $501.19 |
Molina Setting Professional Modifier None Typical Low $39.81 Median $457.09 Typical High $660.69 | Professional | None | $39.81 | $457.09 | $660.69 |
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 $54.95 Median $562.34 Typical High $1,288.25 | Professional | None | $54.95 | $562.34 | $1,288.25 |
Wellpoint Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $512.86 | Professional | None | $354.81 | $354.81 | $512.86 |
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 $208.93 Median $229.09 Typical High $288.40 | Professional | 52 · Reduced service | $208.93 | $229.09 | $288.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $91.20 Typical High $114.82 | Professional | 53 · Discontinued | $83.18 | $91.20 | $114.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $338.84 Typical High $436.52 | Professional | 54 · Surgery only | $316.23 | $338.84 | $436.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $67.61 Typical High $87.10 | Professional | 55 · Aftercare only | $63.10 | $67.61 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $45.71 Typical High $57.54 | Professional | 56 · Pre-op care only | $41.69 | $45.71 | $57.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $295.12 Median $316.23 Typical High $407.38 | Professional | 78 · Unplanned return to OR | $295.12 | $316.23 | $407.38 |
Where Florida sits
The same service costs 5.4 times more in Alaska 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· 9th 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.