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 $602.56 Median $3,981.07 Typical High $10,964.78 | Facility | None | $602.56 | $3,981.07 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $501.19 Median $1,023.29 Typical High $1,862.09 | Professional | None | $501.19 | $1,023.29 | $1,862.09 |
AvMed Setting Facility Modifier None Typical Low $630.96 Median $2,137.96 Typical High $11,748.98 | Facility | None | $630.96 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $380.19 Median $1,148.15 Typical High $2,344.23 | Professional | None | $380.19 | $1,148.15 | $2,344.23 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $1,380.38 Typical High $2,691.53 | Facility | None | $501.19 | $1,380.38 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $281.84 Median $954.99 Typical High $2,691.53 | Professional | None | $281.84 | $954.99 | $2,691.53 |
Florida Blue Setting Facility Modifier None Typical Low $1,659.59 Median $3,548.13 Typical High $16,982.44 | Facility | None | $1,659.59 | $3,548.13 | $16,982.44 |
Florida Blue Setting Professional Modifier None Typical Low $954.99 Median $1,047.13 Typical High $2,454.71 | Professional | None | $954.99 | $1,047.13 | $2,454.71 |
Molina Setting Professional Modifier None Typical Low $104.71 Median $1,096.48 Typical High $2,344.23 | Professional | None | $104.71 | $1,096.48 | $2,344.23 |
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 $323.59 Median $1,148.15 Typical High $3,162.28 | Professional | None | $323.59 | $1,148.15 | $3,162.28 |
Wellpoint Setting Professional Modifier None Typical Low $275.42 Median $851.14 Typical High $851.14 | Professional | None | $275.42 | $851.14 | $851.14 |
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 $263.03 Median $616.60 Typical High $933.25 | Professional | 52 · Reduced service | $263.03 | $616.60 | $933.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $245.47 Typical High $371.54 | Professional | 53 · Discontinued | $104.71 | $245.47 | $371.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $933.25 Typical High $1,412.54 | Professional | 54 · Surgery only | $389.05 | $933.25 | $1,412.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $186.21 Typical High $281.84 | Professional | 55 · Aftercare only | $79.43 | $186.21 | $281.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $123.03 Typical High $186.21 | Professional | 56 · Pre-op care only | $52.48 | $123.03 | $186.21 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $363.08 Median $870.96 Typical High $1,318.26 | Professional | 78 · Unplanned return to OR | $363.08 | $870.96 | $1,318.26 |
Where Florida sits
The same service costs 4.9 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· 39th of 51
$1,318
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.