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 $776.25 Median $851.14 Typical High $1,047.13 | Professional | None | $776.25 | $851.14 | $1,047.13 |
AvMed Setting Facility Modifier None Typical Low $660.69 Median $2,137.96 Typical High $11,748.98 | Facility | None | $660.69 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $676.08 Median $912.01 Typical High $1,000.00 | Professional | None | $676.08 | $912.01 | $1,000.00 |
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 $630.96 Median $891.25 Typical High $1,698.24 | Professional | None | $630.96 | $891.25 | $1,698.24 |
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 $575.44 Median $616.60 Typical High $954.99 | Professional | None | $575.44 | $616.60 | $954.99 |
Molina Setting Professional Modifier None Typical Low $69.18 Median $741.31 Typical High $1,479.11 | Professional | None | $69.18 | $741.31 | $1,479.11 |
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 $60.26 Median $977.24 Typical High $1,862.09 | Professional | None | $60.26 | $977.24 | $1,862.09 |
Wellpoint Setting Professional Modifier None Typical Low $616.60 Median $616.60 Typical High $812.83 | Professional | None | $616.60 | $616.60 | $812.83 |
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 $380.19 Median $426.58 Typical High $512.86 | Professional | 52 · Reduced service | $380.19 | $426.58 | $512.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $169.82 Typical High $204.17 | Professional | 53 · Discontinued | $154.88 | $169.82 | $204.17 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $645.65 Typical High $776.25 | Professional | 54 · Surgery only | $575.44 | $645.65 | $776.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $128.82 Typical High $154.88 | Professional | 55 · Aftercare only | $114.82 | $128.82 | $154.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $85.11 Typical High $102.33 | Professional | 56 · Pre-op care only | $77.62 | $85.11 | $102.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $602.56 Typical High $724.44 | Professional | 78 · Unplanned return to OR | $537.03 | $602.56 | $724.44 |
Where Florida sits
The same service costs 5.6 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
$813
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.