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 $4,786.30 Typical High $11,748.98 | Facility | None | $707.95 | $4,786.30 | $11,748.98 |
Aetna Setting Professional Modifier None Typical Low $724.44 Median $758.58 Typical High $1,023.29 | Professional | None | $724.44 | $758.58 | $1,023.29 |
AvMed Setting Facility Modifier None Typical Low $616.60 Median $2,089.30 Typical High $9,772.37 | Facility | None | $616.60 | $2,089.30 | $9,772.37 |
AvMed Setting Professional Modifier None Typical Low $630.96 Median $851.14 Typical High $933.25 | Professional | None | $630.96 | $851.14 | $933.25 |
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 $575.44 Median $831.76 Typical High $1,584.89 | Professional | None | $575.44 | $831.76 | $1,584.89 |
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 $537.03 Median $575.44 Typical High $954.99 | Professional | None | $537.03 | $575.44 | $954.99 |
Molina Setting Professional Modifier None Typical Low $69.18 Median $660.69 Typical High $1,380.38 | Professional | None | $69.18 | $660.69 | $1,380.38 |
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 $912.01 Typical High $1,737.80 | Professional | None | $60.26 | $912.01 | $1,737.80 |
Wellpoint Setting Professional Modifier None Typical Low $575.44 Median $575.44 Typical High $758.58 | Professional | None | $575.44 | $575.44 | $758.58 |
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 $363.08 Median $380.19 Typical High $489.78 | Professional | 52 · Reduced service | $363.08 | $380.19 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $151.36 Typical High $194.98 | Professional | 53 · Discontinued | $144.54 | $151.36 | $194.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $562.34 Typical High $724.44 | Professional | 54 · Surgery only | $537.03 | $562.34 | $724.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $114.82 Typical High $144.54 | Professional | 55 · Aftercare only | $107.15 | $114.82 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $75.86 Typical High $97.72 | Professional | 56 · Pre-op care only | $72.44 | $75.86 | $97.72 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $524.81 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $501.19 | $524.81 | $676.08 |
Where Florida sits
The same service costs 6.6 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
$891
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.