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 $630.96 Median $4,786.30 Typical High $11,748.98 | Facility | None | $630.96 | $4,786.30 | $11,748.98 |
Aetna Setting Professional Modifier None Typical Low $630.96 Median $630.96 Typical High $891.25 | Professional | None | $630.96 | $630.96 | $891.25 |
AvMed Setting Facility Modifier None Typical Low $549.54 Median $2,137.96 Typical High $9,772.37 | Facility | None | $549.54 | $2,137.96 | $9,772.37 |
AvMed Setting Professional Modifier None Typical Low $549.54 Median $724.44 Typical High $831.76 | Professional | None | $549.54 | $724.44 | $831.76 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $2,691.53 Typical High $4,786.30 | Facility | None | $501.19 | $2,691.53 | $4,786.30 |
Cigna Setting Professional Modifier None Typical Low $512.86 Median $707.95 Typical High $1,380.38 | Professional | None | $512.86 | $707.95 | $1,380.38 |
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 $467.74 Median $501.19 Typical High $812.83 | Professional | None | $467.74 | $501.19 | $812.83 |
Molina Setting Professional Modifier None Typical Low $69.18 Median $575.44 Typical High $1,174.90 | Professional | None | $69.18 | $575.44 | $1,174.90 |
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 $794.33 Typical High $1,513.56 | Professional | None | $60.26 | $794.33 | $1,513.56 |
Wellpoint Setting Professional Modifier None Typical Low $501.19 Median $501.19 Typical High $660.69 | Professional | None | $501.19 | $501.19 | $660.69 |
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 $316.23 Median $316.23 Typical High $416.87 | Professional | 52 · Reduced service | $316.23 | $316.23 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $125.89 Typical High $169.82 | Professional | 53 · Discontinued | $125.89 | $125.89 | $169.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $467.74 Typical High $630.96 | Professional | 54 · Surgery only | $467.74 | $467.74 | $630.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $93.33 Typical High $125.89 | Professional | 55 · Aftercare only | $93.33 | $93.33 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $63.10 Typical High $83.18 | Professional | 56 · Pre-op care only | $63.10 | $63.10 | $83.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $436.52 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $436.52 | $436.52 | $588.84 |
Where Florida sits
The same service costs 8.7 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· 46th of 51
$794
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.