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 $645.65 Median $5,495.41 Typical High $12,022.64 | Facility | None | $645.65 | $5,495.41 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $501.19 Median $524.81 Typical High $691.83 | Professional | None | $501.19 | $524.81 | $691.83 |
AvMed Setting Facility Modifier None Typical Low $501.19 Median $2,187.76 Typical High $11,748.98 | Facility | None | $501.19 | $2,187.76 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $478.63 Median $602.56 Typical High $707.95 | Professional | None | $478.63 | $602.56 | $707.95 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $2,630.27 Typical High $4,073.80 | Facility | None | $501.19 | $2,630.27 | $4,073.80 |
Cigna Setting Professional Modifier None Typical Low $446.68 Median $616.60 Typical High $1,174.90 | Professional | None | $446.68 | $616.60 | $1,174.90 |
Florida Blue Setting Facility Modifier None Typical Low $1,659.59 Median $3,548.13 Typical High $16,982.44 | Facility | None | $1,659.59 | $3,548.13 | $16,982.44 |
Florida Blue Setting Professional Modifier None Typical Low $398.11 Median $426.58 Typical High $660.69 | Professional | None | $398.11 | $426.58 | $660.69 |
Molina Setting Professional Modifier None Typical Low $69.18 Median $467.74 Typical High $912.01 | Professional | None | $69.18 | $467.74 | $912.01 |
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 $676.08 Typical High $1,288.25 | Professional | None | $60.26 | $676.08 | $1,288.25 |
Wellpoint Setting Professional Modifier None Typical Low $426.58 Median $426.58 Typical High $575.44 | Professional | None | $426.58 | $426.58 | $575.44 |
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 $251.19 Median $263.03 Typical High $331.13 | Professional | 52 · Reduced service | $251.19 | $263.03 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $104.71 Typical High $131.83 | Professional | 53 · Discontinued | $102.33 | $104.71 | $131.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $389.05 Typical High $501.19 | Professional | 54 · Surgery only | $380.19 | $389.05 | $501.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $77.62 Typical High $100.00 | Professional | 55 · Aftercare only | $75.86 | $77.62 | $100.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $52.48 Typical High $66.07 | Professional | 56 · Pre-op care only | $50.12 | $52.48 | $66.07 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $354.81 Median $363.08 Typical High $467.74 | Professional | 78 · Unplanned return to OR | $354.81 | $363.08 | $467.74 |
Where Florida sits
The same service costs 6.2 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· 45th of 51
$646
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.