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 $660.69 Median $5,495.41 Typical High $12,022.64 | Facility | None | $660.69 | $5,495.41 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $630.96 Median $660.69 Typical High $870.96 | Professional | None | $630.96 | $660.69 | $870.96 |
AvMed Setting Facility Modifier None Typical Low $588.84 Median $3,019.95 Typical High $11,748.98 | Facility | None | $588.84 | $3,019.95 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $588.84 Median $758.58 Typical High $851.14 | Professional | None | $588.84 | $758.58 | $851.14 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $3,162.28 Typical High $5,754.40 | Facility | None | $501.19 | $3,162.28 | $5,754.40 |
Cigna Setting Professional Modifier None Typical Low $549.54 Median $741.31 Typical High $1,412.54 | Professional | None | $549.54 | $741.31 | $1,412.54 |
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 $489.78 Median $524.81 Typical High $794.33 | Professional | None | $489.78 | $524.81 | $794.33 |
Molina Setting Professional Modifier None Typical Low $104.71 Median $602.56 Typical High $1,202.26 | Professional | None | $104.71 | $602.56 | $1,202.26 |
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 $831.76 Typical High $1,584.89 | Professional | None | $60.26 | $831.76 | $1,584.89 |
Wellpoint Setting Professional Modifier None Typical Low $537.03 Median $537.03 Typical High $707.95 | Professional | None | $537.03 | $537.03 | $707.95 |
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 $331.13 Typical High $407.38 | Professional | 52 · Reduced service | $316.23 | $331.13 | $407.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $131.83 Typical High $162.18 | Professional | 53 · Discontinued | $125.89 | $131.83 | $162.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $489.78 Typical High $616.60 | Professional | 54 · Surgery only | $478.63 | $489.78 | $616.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $97.72 Typical High $123.03 | Professional | 55 · Aftercare only | $95.50 | $97.72 | $123.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $66.07 Typical High $81.28 | Professional | 56 · Pre-op care only | $63.10 | $66.07 | $81.28 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $457.09 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $446.68 | $457.09 | $575.44 |
Where Florida sits
The same service costs 6.8 times more in Oklahoma than in Texas. 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
$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.