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 $707.95 Median $4,073.80 Typical High $11,481.54 | Facility | None | $707.95 | $4,073.80 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $758.58 Median $812.83 Typical High $1,047.13 | Professional | None | $758.58 | $812.83 | $1,047.13 |
AvMed Setting Facility Modifier None Typical Low $512.86 Median $1,995.26 Typical High $9,549.93 | Facility | None | $512.86 | $1,995.26 | $9,549.93 |
AvMed Setting Professional Modifier None Typical Low $676.08 Median $891.25 Typical High $1,000.00 | Professional | None | $676.08 | $891.25 | $1,000.00 |
Cigna Setting Facility Modifier None Typical Low $436.52 Median $2,570.40 Typical High $4,786.30 | Facility | None | $436.52 | $2,570.40 | $4,786.30 |
Cigna Setting Professional Modifier None Typical Low $616.60 Median $870.96 Typical High $1,698.24 | Professional | None | $616.60 | $870.96 | $1,698.24 |
Florida Blue Setting Facility Modifier None Typical Low $1,318.26 Median $2,630.27 Typical High $16,982.44 | Facility | None | $1,318.26 | $2,630.27 | $16,982.44 |
Florida Blue Setting Professional Modifier None Typical Low $562.34 Median $602.56 Typical High $954.99 | Professional | None | $562.34 | $602.56 | $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 $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 $60.26 Median $954.99 Typical High $1,819.70 | Professional | None | $60.26 | $954.99 | $1,819.70 |
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 $407.38 Typical High $512.86 | Professional | 52 · Reduced service | $380.19 | $407.38 | $512.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $162.18 Typical High $204.17 | Professional | 53 · Discontinued | $154.88 | $162.18 | $204.17 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $616.60 Typical High $758.58 | Professional | 54 · Surgery only | $575.44 | $616.60 | $758.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $123.03 Typical High $151.36 | Professional | 55 · Aftercare only | $114.82 | $123.03 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $81.28 Typical High $102.33 | Professional | 56 · Pre-op care only | $75.86 | $81.28 | $102.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $575.44 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $537.03 | $575.44 | $707.95 |
Where Florida sits
The same service costs 5.6 times more in Alaska 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· 47th of 51
$933
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.