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 $758.58 Median $6,025.60 Typical High $12,882.50 | Facility | None | $758.58 | $6,025.60 | $12,882.50 |
Aetna Setting Professional Modifier None Typical Low $512.86 Median $537.03 Typical High $691.83 | Professional | None | $512.86 | $537.03 | $691.83 |
AvMed Setting Facility Modifier None Typical Low $478.63 Median $2,187.76 Typical High $11,748.98 | Facility | None | $478.63 | $2,187.76 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $457.09 Median $602.56 Typical High $676.08 | Professional | None | $457.09 | $602.56 | $676.08 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $2,630.27 Typical High $4,073.80 | Facility | None | $501.19 | $2,630.27 | $4,073.80 |
Cigna Setting Professional Modifier None Typical Low $416.87 Median $588.84 Typical High $1,122.02 | Professional | None | $416.87 | $588.84 | $1,122.02 |
Florida Blue Setting Facility Modifier None Typical Low $2,630.27 Median $5,495.41 Typical High $16,982.44 | Facility | None | $2,630.27 | $5,495.41 | $16,982.44 |
Florida Blue Setting Professional Modifier None Typical Low $380.19 Median $407.38 Typical High $707.95 | Professional | None | $380.19 | $407.38 | $707.95 |
Molina Setting Professional Modifier None Typical Low $72.44 Median $512.86 Typical High $1,000.00 | Professional | None | $72.44 | $512.86 | $1,000.00 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $3,311.31 Typical High $12,589.25 | Facility | None | $1,230.27 | $3,311.31 | $12,589.25 |
United Setting Professional Modifier None Typical Low $60.26 Median $645.65 Typical High $1,230.27 | Professional | None | $60.26 | $645.65 | $1,230.27 |
Wellpoint Setting Professional Modifier None Typical Low $416.87 Median $416.87 Typical High $549.54 | Professional | None | $416.87 | $416.87 | $549.54 |
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 $257.04 Median $269.15 Typical High $338.84 | Professional | 52 · Reduced service | $257.04 | $269.15 | $338.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $107.15 Typical High $134.90 | Professional | 53 · Discontinued | $102.33 | $107.15 | $134.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $407.38 Typical High $512.86 | Professional | 54 · Surgery only | $380.19 | $407.38 | $512.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $81.28 Typical High $102.33 | Professional | 55 · Aftercare only | $75.86 | $81.28 | $102.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $53.70 Typical High $67.61 | Professional | 56 · Pre-op care only | $51.29 | $53.70 | $67.61 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $354.81 Median $380.19 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $354.81 | $380.19 | $478.63 |
Where Florida sits
The same service costs 9.8 times more in Oklahoma than in Utah. 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· 45th of 51
$676
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.