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 $645.65 Median $3,890.45 Typical High $12,022.64 | Facility | None | $645.65 | $3,890.45 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $436.52 Median $501.19 Typical High $602.56 | Professional | None | $436.52 | $501.19 | $602.56 |
AvMed Setting Facility Modifier None Typical Low $501.19 Median $2,137.96 Typical High $11,748.98 | Facility | None | $501.19 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $467.74 Median $537.03 Typical High $676.08 | Professional | None | $467.74 | $537.03 | $676.08 |
Cigna Setting Facility Modifier None Typical Low $331.13 Median $776.25 Typical High $1,659.59 | Facility | None | $331.13 | $776.25 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $416.87 Median $446.68 Typical High $776.25 | Professional | None | $416.87 | $446.68 | $776.25 |
Florida Blue Setting Facility Modifier None Typical Low $616.60 Median $1,348.96 Typical High $6,309.57 | Facility | None | $616.60 | $1,348.96 | $6,309.57 |
Florida Blue Setting Professional Modifier None Typical Low $245.47 Median $562.34 Typical High $676.08 | Professional | None | $245.47 | $562.34 | $676.08 |
Molina Setting Professional Modifier None Typical Low $54.95 Median $436.52 Typical High $1,000.00 | Professional | None | $54.95 | $436.52 | $1,000.00 |
United Setting Facility Modifier None Typical Low $398.11 Median $1,000.00 Typical High $5,623.41 | Facility | None | $398.11 | $1,000.00 | $5,623.41 |
United Setting Professional Modifier None Typical Low $389.05 Median $501.19 Typical High $812.83 | Professional | None | $389.05 | $501.19 | $812.83 |
Wellpoint Setting Professional Modifier None Typical Low $426.58 Median $426.58 Typical High $426.58 | Professional | None | $426.58 | $426.58 | $426.58 |
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 $218.78 Median $251.19 Typical High $302.00 | Professional | 52 · Reduced service | $218.78 | $251.19 | $302.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $87.10 Median $100.00 Typical High $120.23 | Professional | 53 · Discontinued | $87.10 | $100.00 | $120.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $323.59 Median $380.19 Typical High $457.09 | Professional | 54 · Surgery only | $323.59 | $380.19 | $457.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $64.57 Median $75.86 Typical High $91.20 | Professional | 55 · Aftercare only | $64.57 | $75.86 | $91.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $50.12 Typical High $60.26 | Professional | 56 · Pre-op care only | $43.65 | $50.12 | $60.26 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $302.00 Median $354.81 Typical High $426.58 | Professional | 78 · Unplanned return to OR | $302.00 | $354.81 | $426.58 |
Where Florida sits
The same service costs 5.5 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
$479
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.