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 $4,786.30 Typical High $11,748.98 | Facility | None | $660.69 | $4,786.30 | $11,748.98 |
Aetna Setting Professional Modifier None Typical Low $660.69 Median $660.69 Typical High $977.24 | Professional | None | $660.69 | $660.69 | $977.24 |
AvMed Setting Facility Modifier None Typical Low $575.44 Median $2,089.30 Typical High $9,772.37 | Facility | None | $575.44 | $2,089.30 | $9,772.37 |
AvMed Setting Professional Modifier None Typical Low $575.44 Median $776.25 Typical High $851.14 | Professional | None | $575.44 | $776.25 | $851.14 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $1,995.26 Typical High $3,090.30 | Facility | None | $501.19 | $1,995.26 | $3,090.30 |
Cigna Setting Professional Modifier None Typical Low $524.81 Median $758.58 Typical High $1,445.44 | Professional | None | $524.81 | $758.58 | $1,445.44 |
Florida Blue Setting Facility Modifier None Typical Low $1,230.27 Median $2,630.27 Typical High $16,982.44 | Facility | None | $1,230.27 | $2,630.27 | $16,982.44 |
Florida Blue Setting Professional Modifier None Typical Low $489.78 Median $524.81 Typical High $891.25 | Professional | None | $489.78 | $524.81 | $891.25 |
Molina Setting Professional Modifier None Typical Low $69.18 Median $616.60 Typical High $1,230.27 | Professional | None | $69.18 | $616.60 | $1,230.27 |
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 $831.76 Typical High $1,584.89 | Professional | None | $60.26 | $831.76 | $1,584.89 |
Wellpoint Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $691.83 | Professional | None | $524.81 | $524.81 | $691.83 |
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 $331.13 Median $331.13 Typical High $436.52 | Professional | 52 · Reduced service | $331.13 | $331.13 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $131.83 Typical High $177.83 | Professional | 53 · Discontinued | $131.83 | $131.83 | $177.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $501.19 Typical High $660.69 | Professional | 54 · Surgery only | $489.78 | $501.19 | $660.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $100.00 Typical High $131.83 | Professional | 55 · Aftercare only | $97.72 | $100.00 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $66.07 Typical High $89.13 | Professional | 56 · Pre-op care only | $66.07 | $66.07 | $89.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $457.09 Median $467.74 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $457.09 | $467.74 | $616.60 |
Where Florida sits
The same service costs 7.9 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· 47th of 51
$832
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.