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 $6,918.31 Typical High $14,454.40 | Facility | None | $776.25 | $6,918.31 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $363.08 Median $371.54 Typical High $575.44 | Professional | None | $363.08 | $371.54 | $575.44 |
AvMed Setting Facility Modifier None Typical Low $501.19 Median $3,801.89 Typical High $9,549.93 | Facility | None | $501.19 | $3,801.89 | $9,549.93 |
AvMed Setting Professional Modifier None Typical Low $338.84 Median $436.52 Typical High $478.63 | Professional | None | $338.84 | $436.52 | $478.63 |
Cigna Setting Facility Modifier None Typical Low $1,288.25 Median $3,548.13 Typical High $6,760.83 | Facility | None | $1,288.25 | $3,548.13 | $6,760.83 |
Cigna Setting Professional Modifier None Typical Low $302.00 Median $436.52 Typical High $812.83 | Professional | None | $302.00 | $436.52 | $812.83 |
Florida Blue Setting Facility Modifier None Typical Low $1,737.80 Median $3,548.13 Typical High $16,982.44 | Facility | None | $1,737.80 | $3,548.13 | $16,982.44 |
Florida Blue Setting Professional Modifier None Typical Low $281.84 Median $302.00 Typical High $446.68 | Professional | None | $281.84 | $302.00 | $446.68 |
Molina Setting Professional Modifier None Typical Low $70.79 Median $426.58 Typical High $812.83 | Professional | None | $70.79 | $426.58 | $812.83 |
United Setting Facility Modifier None Typical Low $1,584.89 Median $4,073.80 Typical High $15,488.17 | Facility | None | $1,584.89 | $4,073.80 | $15,488.17 |
United Setting Professional Modifier None Typical Low $60.26 Median $467.74 Typical High $891.25 | Professional | None | $60.26 | $467.74 | $891.25 |
Wellpoint Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $407.38 | Professional | None | $309.03 | $309.03 | $407.38 |
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 $181.97 Median $186.21 Typical High $251.19 | Professional | 52 · Reduced service | $181.97 | $186.21 | $251.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $72.44 Median $74.13 Typical High $102.33 | Professional | 53 · Discontinued | $72.44 | $74.13 | $102.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $275.42 Median $281.84 Typical High $380.19 | Professional | 54 · Surgery only | $275.42 | $281.84 | $380.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $56.23 Typical High $75.86 | Professional | 55 · Aftercare only | $54.95 | $56.23 | $75.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $37.15 Typical High $50.12 | Professional | 56 · Pre-op care only | $36.31 | $37.15 | $50.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $257.04 Median $263.03 Typical High $354.81 | Professional | 78 · Unplanned return to OR | $257.04 | $263.03 | $354.81 |
Where Florida sits
The same service costs 9.5 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· 25th of 51
$676
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.