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 $489.78 Median $588.84 Typical High $676.08 | Professional | None | $489.78 | $588.84 | $676.08 |
AvMed Setting Facility Modifier None Typical Low $616.60 Median $3,715.35 Typical High $9,772.37 | Facility | None | $616.60 | $3,715.35 | $9,772.37 |
AvMed Setting Professional Modifier None Typical Low $489.78 Median $588.84 Typical High $724.44 | Professional | None | $489.78 | $588.84 | $724.44 |
Cigna Setting Facility Modifier None Typical Low $1,258.93 Median $2,041.74 Typical High $6,760.83 | Facility | None | $1,258.93 | $2,041.74 | $6,760.83 |
Cigna Setting Professional Modifier None Typical Low $446.68 Median $478.63 Typical High $851.14 | Professional | None | $446.68 | $478.63 | $851.14 |
Florida Blue Setting Facility Modifier None Typical Low $1,230.27 Median $2,630.27 Typical High $16,982.44 | Facility | None | $1,230.27 | $2,630.27 | $16,982.44 |
Florida Blue Setting Professional Modifier None Typical Low $281.84 Median $512.86 Typical High $707.95 | Professional | None | $281.84 | $512.86 | $707.95 |
Molina Setting Professional Modifier None Typical Low $54.95 Median $457.09 Typical High $1,047.13 | Professional | None | $54.95 | $457.09 | $1,047.13 |
United Setting Facility Modifier None Typical Low $954.99 Median $2,344.23 Typical High $10,000.00 | Facility | None | $954.99 | $2,344.23 | $10,000.00 |
United Setting Professional Modifier None Typical Low $426.58 Median $537.03 Typical High $891.25 | Professional | None | $426.58 | $537.03 | $891.25 |
Wellpoint Setting Professional Modifier None Typical Low $457.09 Median $457.09 Typical High $457.09 | Professional | None | $457.09 | $457.09 | $457.09 |
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 $245.47 Median $295.12 Typical High $331.13 | Professional | 52 · Reduced service | $245.47 | $295.12 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $117.49 Typical High $131.83 | Professional | 53 · Discontinued | $97.72 | $117.49 | $131.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $446.68 Typical High $489.78 | Professional | 54 · Surgery only | $371.54 | $446.68 | $489.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $89.13 Typical High $97.72 | Professional | 55 · Aftercare only | $74.13 | $89.13 | $97.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $58.88 Typical High $66.07 | Professional | 56 · Pre-op care only | $48.98 | $58.88 | $66.07 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $346.74 Median $416.87 Typical High $457.09 | Professional | 78 · Unplanned return to OR | $346.74 | $416.87 | $457.09 |
Where Florida sits
The same service costs 5.9 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
$513
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.