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 $851.14 Median $6,025.60 Typical High $12,882.50 | Facility | None | $851.14 | $6,025.60 | $12,882.50 |
Aetna Setting Professional Modifier None Typical Low $1,071.52 Median $1,122.02 Typical High $1,445.44 | Professional | None | $1,071.52 | $1,122.02 | $1,445.44 |
AvMed Setting Facility Modifier None Typical Low $954.99 Median $3,019.95 Typical High $11,748.98 | Facility | None | $954.99 | $3,019.95 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $1,000.00 Median $1,348.96 Typical High $1,548.82 | Professional | None | $1,000.00 | $1,348.96 | $1,548.82 |
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 $954.99 Median $1,318.26 Typical High $2,511.89 | Professional | None | $954.99 | $1,318.26 | $2,511.89 |
Florida Blue Setting Facility Modifier None Typical Low $1,071.52 Median $2,089.30 Typical High $16,982.44 | Facility | None | $1,071.52 | $2,089.30 | $16,982.44 |
Florida Blue Setting Professional Modifier None Typical Low $851.14 Median $912.01 Typical High $1,380.38 | Professional | None | $851.14 | $912.01 | $1,380.38 |
Molina Setting Professional Modifier None Typical Low $138.04 Median $912.01 Typical High $1,862.09 | Professional | None | $138.04 | $912.01 | $1,862.09 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $3,311.31 Typical High $12,589.25 | Facility | None | $1,230.27 | $3,311.31 | $12,589.25 |
United Setting Professional Modifier None Typical Low $60.26 Median $1,479.11 Typical High $2,754.23 | Professional | None | $60.26 | $1,479.11 | $2,754.23 |
Wellpoint Setting Professional Modifier None Typical Low $912.01 Median $912.01 Typical High $1,202.26 | Professional | None | $912.01 | $912.01 | $1,202.26 |
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 $562.34 Median $562.34 Typical High $707.95 | Professional | 52 · Reduced service | $562.34 | $562.34 | $707.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $223.87 Typical High $281.84 | Professional | 53 · Discontinued | $223.87 | $223.87 | $281.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $831.76 Median $851.14 Typical High $1,071.52 | Professional | 54 · Surgery only | $831.76 | $851.14 | $1,071.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $169.82 Typical High $213.80 | Professional | 55 · Aftercare only | $165.96 | $169.82 | $213.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $112.20 Typical High $141.25 | Professional | 56 · Pre-op care only | $112.20 | $112.20 | $141.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $776.25 Median $794.33 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $776.25 | $794.33 | $1,000.00 |
Where Florida sits
The same service costs 6.9 times more in Alaska 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
$1,202
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.