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 $660.69 Median $4,073.80 Typical High $12,022.64 | Facility | None | $660.69 | $4,073.80 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $691.83 Median $741.31 Typical High $933.25 | Professional | None | $691.83 | $741.31 | $933.25 |
AvMed Setting Facility Modifier None Typical Low $549.54 Median $1,995.26 Typical High $13,182.57 | Facility | None | $549.54 | $1,995.26 | $13,182.57 |
AvMed Setting Professional Modifier None Typical Low $616.60 Median $812.83 Typical High $891.25 | Professional | None | $616.60 | $812.83 | $891.25 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $16,595.87 Typical High $32,359.37 | Facility | None | $446.68 | $16,595.87 | $32,359.37 |
Cigna Setting Professional Modifier None Typical Low $562.34 Median $794.33 Typical High $1,513.56 | Professional | None | $562.34 | $794.33 | $1,513.56 |
Florida Blue Setting Facility Modifier None Typical Low $2,884.03 Median $5,888.44 Typical High $16,982.44 | Facility | None | $2,884.03 | $5,888.44 | $16,982.44 |
Florida Blue Setting Professional Modifier None Typical Low $512.86 Median $549.54 Typical High $851.14 | Professional | None | $512.86 | $549.54 | $851.14 |
Molina Setting Professional Modifier None Typical Low $54.95 Median $630.96 Typical High $1,318.26 | Professional | None | $54.95 | $630.96 | $1,318.26 |
United Setting Facility Modifier None Typical Low $2,511.89 Median $10,000.00 Typical High $21,379.62 | Facility | None | $2,511.89 | $10,000.00 | $21,379.62 |
United Setting Professional Modifier None Typical Low $60.26 Median $870.96 Typical High $1,659.59 | Professional | None | $60.26 | $870.96 | $1,659.59 |
Wellpoint Setting Professional Modifier None Typical Low $562.34 Median $562.34 Typical High $741.31 | Professional | None | $562.34 | $562.34 | $741.31 |
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 $346.74 Median $363.08 Typical High $457.09 | Professional | 52 · Reduced service | $346.74 | $363.08 | $457.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $147.91 Typical High $186.21 | Professional | 53 · Discontinued | $138.04 | $147.91 | $186.21 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $549.54 Typical High $691.83 | Professional | 54 · Surgery only | $524.81 | $549.54 | $691.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $109.65 Typical High $138.04 | Professional | 55 · Aftercare only | $104.71 | $109.65 | $138.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $74.13 Typical High $93.33 | Professional | 56 · Pre-op care only | $69.18 | $74.13 | $93.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $512.86 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $489.78 | $512.86 | $645.65 |
Where Florida sits
The same service costs 6.8 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· 46th of 51
$851
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.