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 $512.86 Median $602.56 Typical High $660.69 | Professional | None | $512.86 | $602.56 | $660.69 |
AvMed Setting Facility Modifier None Typical Low $549.54 Median $2,137.96 Typical High $9,772.37 | Facility | None | $549.54 | $2,137.96 | $9,772.37 |
AvMed Setting Professional Modifier None Typical Low $436.52 Median $549.54 Typical High $660.69 | Professional | None | $436.52 | $549.54 | $660.69 |
Cigna Setting Facility Modifier None Typical Low $616.60 Median $1,737.80 Typical High $3,311.31 | Facility | None | $616.60 | $1,737.80 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $436.52 Median $457.09 Typical High $851.14 | Professional | None | $436.52 | $457.09 | $851.14 |
Florida Blue Setting Facility Modifier None Typical Low $1,659.59 Median $3,548.13 Typical High $16,982.44 | Facility | None | $1,659.59 | $3,548.13 | $16,982.44 |
Florida Blue Setting Professional Modifier None Typical Low $288.40 Median $588.84 Typical High $676.08 | Professional | None | $288.40 | $588.84 | $676.08 |
Molina Setting Professional Modifier None Typical Low $54.95 Median $407.38 Typical High $977.24 | Professional | None | $54.95 | $407.38 | $977.24 |
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 $436.52 Median $549.54 Typical High $912.01 | Professional | None | $436.52 | $549.54 | $912.01 |
Wellpoint Setting Professional Modifier None Typical Low $416.87 Median $416.87 Typical High $416.87 | Professional | None | $416.87 | $416.87 | $416.87 |
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 $257.04 Median $302.00 Typical High $331.13 | Professional | 52 · Reduced service | $257.04 | $302.00 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $120.23 Typical High $131.83 | Professional | 53 · Discontinued | $102.33 | $120.23 | $131.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $457.09 Typical High $489.78 | Professional | 54 · Surgery only | $380.19 | $457.09 | $489.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $91.20 Typical High $97.72 | Professional | 55 · Aftercare only | $75.86 | $91.20 | $97.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $60.26 Typical High $66.07 | Professional | 56 · Pre-op care only | $51.29 | $60.26 | $66.07 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $354.81 Median $426.58 Typical High $457.09 | Professional | 78 · Unplanned return to OR | $354.81 | $426.58 | $457.09 |
Where Florida sits
The same service costs 6.5 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
$490
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.