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 $4,786.30 Typical High $11,748.98 | Facility | None | $630.96 | $4,786.30 | $11,748.98 |
Aetna Setting Professional Modifier None Typical Low $407.38 Median $467.74 Typical High $537.03 | Professional | None | $407.38 | $467.74 | $537.03 |
AvMed Setting Facility Modifier None Typical Low $501.19 Median $2,137.96 Typical High $9,772.37 | Facility | None | $501.19 | $2,137.96 | $9,772.37 |
AvMed Setting Professional Modifier None Typical Low $354.81 Median $446.68 Typical High $537.03 | Professional | None | $354.81 | $446.68 | $537.03 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $2,818.38 Typical High $5,370.32 | Facility | None | $501.19 | $2,818.38 | $5,370.32 |
Cigna Setting Professional Modifier None Typical Low $354.81 Median $371.54 Typical High $691.83 | Professional | None | $354.81 | $371.54 | $691.83 |
Florida Blue Setting Facility Modifier None Typical Low $1,737.80 Median $3,548.13 Typical High $16,982.44 | Facility | None | $1,737.80 | $3,548.13 | $16,982.44 |
Florida Blue Setting Professional Modifier None Typical Low $234.42 Median $478.63 Typical High $537.03 | Professional | None | $234.42 | $478.63 | $537.03 |
Molina Setting Professional Modifier None Typical Low $54.95 Median $346.74 Typical High $831.76 | Professional | None | $54.95 | $346.74 | $831.76 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $3,311.31 Typical High $12,589.25 | Facility | None | $1,230.27 | $3,311.31 | $12,589.25 |
United Setting Professional Modifier None Typical Low $346.74 Median $436.52 Typical High $724.44 | Professional | None | $346.74 | $436.52 | $724.44 |
Wellpoint Setting Professional Modifier None Typical Low $346.74 Median $346.74 Typical High $346.74 | Professional | None | $346.74 | $346.74 | $346.74 |
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 $204.17 Median $234.42 Typical High $269.15 | Professional | 52 · Reduced service | $204.17 | $234.42 | $269.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $93.33 Typical High $107.15 | Professional | 53 · Discontinued | $83.18 | $93.33 | $107.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $354.81 Typical High $398.11 | Professional | 54 · Surgery only | $309.03 | $354.81 | $398.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $70.79 Typical High $81.28 | Professional | 55 · Aftercare only | $61.66 | $70.79 | $81.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $46.77 Typical High $53.70 | Professional | 56 · Pre-op care only | $40.74 | $46.77 | $53.70 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $331.13 Typical High $371.54 | Professional | 78 · Unplanned return to OR | $288.40 | $331.13 | $371.54 |
Where Florida sits
The same service costs 6.3 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· 49th of 51
$407
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.