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 $776.25 Median $6,025.60 Typical High $12,022.64 | Facility | None | $776.25 | $6,025.60 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $616.60 Median $645.65 Typical High $891.25 | Professional | None | $616.60 | $645.65 | $891.25 |
AvMed Setting Facility Modifier None Typical Low $549.54 Median $2,137.96 Typical High $11,748.98 | Facility | None | $549.54 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $549.54 Median $724.44 Typical High $794.33 | Professional | None | $549.54 | $724.44 | $794.33 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $2,041.74 Typical High $3,467.37 | Facility | None | $501.19 | $2,041.74 | $3,467.37 |
Cigna Setting Professional Modifier None Typical Low $501.19 Median $707.95 Typical High $1,380.38 | Professional | None | $501.19 | $707.95 | $1,380.38 |
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 $467.74 Median $501.19 Typical High $776.25 | Professional | None | $467.74 | $501.19 | $776.25 |
Molina Setting Professional Modifier None Typical Low $69.18 Median $588.84 Typical High $1,174.90 | Professional | None | $69.18 | $588.84 | $1,174.90 |
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 $794.33 Typical High $1,479.11 | Professional | None | $60.26 | $794.33 | $1,479.11 |
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 $309.03 Median $323.59 Typical High $416.87 | Professional | 52 · Reduced service | $309.03 | $323.59 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $128.82 Typical High $165.96 | Professional | 53 · Discontinued | $123.03 | $128.82 | $165.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $478.63 Typical High $630.96 | Professional | 54 · Surgery only | $457.09 | $478.63 | $630.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $97.72 Typical High $125.89 | Professional | 55 · Aftercare only | $91.20 | $97.72 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $64.57 Typical High $83.18 | Professional | 56 · Pre-op care only | $61.66 | $64.57 | $83.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $446.68 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $426.58 | $446.68 | $588.84 |
Where Florida sits
The same service costs 6.3 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
$776
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.