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 $3,890.45 Typical High $12,022.64 | Facility | None | $776.25 | $3,890.45 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $794.33 Median $954.99 Typical High $1,096.48 | Professional | None | $794.33 | $954.99 | $1,096.48 |
AvMed Setting Facility Modifier None Typical Low $812.83 Median $2,137.96 Typical High $11,748.98 | Facility | None | $812.83 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $812.83 Median $954.99 Typical High $1,174.90 | Professional | None | $812.83 | $954.99 | $1,174.90 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $501.19 Typical High $2,691.53 | Facility | None | $398.11 | $501.19 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $724.44 Median $776.25 Typical High $1,380.38 | Professional | None | $724.44 | $776.25 | $1,380.38 |
Florida Blue Setting Facility Modifier None Typical Low $10,471.29 Median $22,387.21 Typical High $33,884.42 | Facility | None | $10,471.29 | $22,387.21 | $33,884.42 |
Florida Blue Setting Professional Modifier None Typical Low $457.09 Median $912.01 Typical High $1,174.90 | Professional | None | $457.09 | $912.01 | $1,174.90 |
Molina Setting Professional Modifier None Typical Low $54.95 Median $794.33 Typical High $1,862.09 | Professional | None | $54.95 | $794.33 | $1,862.09 |
United Setting Facility Modifier None Typical Low $371.54 Median $954.99 Typical High $7,585.78 | Facility | None | $371.54 | $954.99 | $7,585.78 |
United Setting Professional Modifier None Typical Low $691.83 Median $891.25 Typical High $1,479.11 | Professional | None | $691.83 | $891.25 | $1,479.11 |
Wellpoint Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $758.58 | Professional | None | $758.58 | $758.58 | $758.58 |
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 $389.05 Median $478.63 Typical High $537.03 | Professional | 52 · Reduced service | $389.05 | $478.63 | $537.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $190.55 Typical High $218.78 | Professional | 53 · Discontinued | $158.49 | $190.55 | $218.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $724.44 Typical High $812.83 | Professional | 54 · Surgery only | $588.84 | $724.44 | $812.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $144.54 Typical High $162.18 | Professional | 55 · Aftercare only | $117.49 | $144.54 | $162.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $95.50 Typical High $109.65 | Professional | 56 · Pre-op care only | $79.43 | $95.50 | $109.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $676.08 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $549.54 | $676.08 | $758.58 |
Where Florida sits
The same service costs 4.9 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
$832
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.