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 $3,311.31 Typical High $11,481.54 | Facility | None | $707.95 | $3,311.31 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $1,047.13 | Professional | None | $758.58 | $758.58 | $1,047.13 |
AvMed Setting Facility Modifier None Typical Low $676.08 Median $2,630.27 Typical High $13,182.57 | Facility | None | $676.08 | $2,630.27 | $13,182.57 |
AvMed Setting Professional Modifier None Typical Low $676.08 Median $891.25 Typical High $1,000.00 | Professional | None | $676.08 | $891.25 | $1,000.00 |
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 $616.60 Median $870.96 Typical High $1,698.24 | Professional | None | $616.60 | $870.96 | $1,698.24 |
Florida Blue Setting Facility Modifier None Typical Low $891.25 Median $1,819.70 Typical High $16,982.44 | Facility | None | $891.25 | $1,819.70 | $16,982.44 |
Florida Blue Setting Professional Modifier None Typical Low $562.34 Median $602.56 Typical High $933.25 | Professional | None | $562.34 | $602.56 | $933.25 |
Molina Setting Professional Modifier None Typical Low $104.71 Median $724.44 Typical High $1,445.44 | Professional | None | $104.71 | $724.44 | $1,445.44 |
United Setting Facility Modifier None Typical Low $794.33 Median $1,778.28 Typical High $8,511.38 | Facility | None | $794.33 | $1,778.28 | $8,511.38 |
United Setting Professional Modifier None Typical Low $60.26 Median $977.24 Typical High $1,819.70 | Professional | None | $60.26 | $977.24 | $1,819.70 |
Wellpoint Setting Professional Modifier None Typical Low $616.60 Median $616.60 Typical High $812.83 | Professional | None | $616.60 | $616.60 | $812.83 |
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 $380.19 Median $380.19 Typical High $512.86 | Professional | 52 · Reduced service | $380.19 | $380.19 | $512.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $154.88 Typical High $204.17 | Professional | 53 · Discontinued | $154.88 | $154.88 | $204.17 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $575.44 Typical High $776.25 | Professional | 54 · Surgery only | $575.44 | $575.44 | $776.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $114.82 Typical High $154.88 | Professional | 55 · Aftercare only | $114.82 | $114.82 | $154.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $75.86 Typical High $102.33 | Professional | 56 · Pre-op care only | $75.86 | $75.86 | $102.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $537.03 Typical High $724.44 | Professional | 78 · Unplanned return to OR | $537.03 | $537.03 | $724.44 |
Where Florida sits
The same service costs 5.8 times more in Alaska 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· 48th 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.