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 $1,023.29 Median $6,918.31 Typical High $15,135.61 | Facility | None | $1,023.29 | $6,918.31 | $15,135.61 |
Aetna Setting Professional Modifier None Typical Low $954.99 Median $1,000.00 Typical High $1,412.54 | Professional | None | $954.99 | $1,000.00 | $1,412.54 |
AvMed Setting Facility Modifier None Typical Low $870.96 Median $4,365.16 Typical High $12,882.50 | Facility | None | $870.96 | $4,365.16 | $12,882.50 |
AvMed Setting Professional Modifier None Typical Low $870.96 Median $1,148.15 Typical High $1,318.26 | Professional | None | $870.96 | $1,148.15 | $1,318.26 |
Cigna Setting Facility Modifier None Typical Low $724.44 Median $5,495.41 Typical High $14,125.38 | Facility | None | $724.44 | $5,495.41 | $14,125.38 |
Cigna Setting Professional Modifier None Typical Low $812.83 Median $1,122.02 Typical High $2,137.96 | Professional | None | $812.83 | $1,122.02 | $2,137.96 |
Florida Blue Setting Facility Modifier None Typical Low $1,318.26 Median $2,818.38 Typical High $16,982.44 | Facility | None | $1,318.26 | $2,818.38 | $16,982.44 |
Florida Blue Setting Professional Modifier None Typical Low $724.44 Median $776.25 Typical High $1,174.90 | Professional | None | $724.44 | $776.25 | $1,174.90 |
Molina Setting Professional Modifier None Typical Low $104.71 Median $776.25 Typical High $1,621.81 | Professional | None | $104.71 | $776.25 | $1,621.81 |
United Setting Facility Modifier None Typical Low $1,659.59 Median $5,128.61 Typical High $15,488.17 | Facility | None | $1,659.59 | $5,128.61 | $15,488.17 |
United Setting Professional Modifier None Typical Low $60.26 Median $1,258.93 Typical High $2,344.23 | Professional | None | $60.26 | $1,258.93 | $2,344.23 |
Wellpoint Setting Professional Modifier None Typical Low $776.25 Median $776.25 Typical High $1,023.29 | Professional | None | $776.25 | $776.25 | $1,023.29 |
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 $478.63 Median $489.78 Typical High $602.56 | Professional | 52 · Reduced service | $478.63 | $489.78 | $602.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $190.55 Median $199.53 Typical High $239.88 | Professional | 53 · Discontinued | $190.55 | $199.53 | $239.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $741.31 Typical High $912.01 | Professional | 54 · Surgery only | $724.44 | $741.31 | $912.01 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $147.91 Typical High $181.97 | Professional | 55 · Aftercare only | $144.54 | $147.91 | $181.97 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $100.00 Typical High $120.23 | Professional | 56 · Pre-op care only | $95.50 | $100.00 | $120.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $691.83 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $676.08 | $691.83 | $851.14 |
Where Florida sits
The same service costs 8.7 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
$1,096
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.