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 $1,096.48 Median $1,288.25 Typical High $1,445.44 | Professional | None | $1,096.48 | $1,288.25 | $1,445.44 |
AvMed Setting Facility Modifier None Typical Low $1,047.13 Median $2,137.96 Typical High $11,748.98 | Facility | None | $1,047.13 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $1,047.13 Median $1,288.25 Typical High $1,513.56 | Professional | None | $1,047.13 | $1,288.25 | $1,513.56 |
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 $977.24 Median $1,023.29 Typical High $1,819.70 | Professional | None | $977.24 | $1,023.29 | $1,819.70 |
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 $630.96 Median $1,174.90 Typical High $1,513.56 | Professional | None | $630.96 | $1,174.90 | $1,513.56 |
Molina Setting Professional Modifier None Typical Low $128.82 Median $977.24 Typical High $2,238.72 | Professional | None | $128.82 | $977.24 | $2,238.72 |
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 $933.25 Median $1,174.90 Typical High $1,949.84 | Professional | None | $933.25 | $1,174.90 | $1,949.84 |
Wellpoint Setting Professional Modifier None Typical Low $954.99 Median $954.99 Typical High $954.99 | Professional | None | $954.99 | $954.99 | $954.99 |
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 $537.03 Median $645.65 Typical High $707.95 | Professional | 52 · Reduced service | $537.03 | $645.65 | $707.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $218.78 Median $257.04 Typical High $288.40 | Professional | 53 · Discontinued | $218.78 | $257.04 | $288.40 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $954.99 Typical High $1,071.52 | Professional | 54 · Surgery only | $812.83 | $954.99 | $1,071.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $194.98 Typical High $213.80 | Professional | 55 · Aftercare only | $162.18 | $194.98 | $213.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $128.82 Typical High $144.54 | Professional | 56 · Pre-op care only | $109.65 | $128.82 | $144.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $891.25 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $758.58 | $891.25 | $1,000.00 |
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· 49th of 51
$1,096
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.