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 $776.25 Median $6,025.60 Typical High $12,882.50 | Facility | None | $776.25 | $6,025.60 | $12,882.50 |
Aetna Setting Professional Modifier None Typical Low $758.58 Median $812.83 Typical High $1,000.00 | Professional | None | $758.58 | $812.83 | $1,000.00 |
AvMed Setting Facility Modifier None Typical Low $676.08 Median $2,137.96 Typical High $11,748.98 | Facility | None | $676.08 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $707.95 Median $912.01 Typical High $1,071.52 | Professional | None | $707.95 | $912.01 | $1,071.52 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $501.19 Typical High $2,691.53 | Facility | None | $398.11 | $501.19 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $660.69 Median $912.01 Typical High $1,778.28 | Professional | None | $660.69 | $912.01 | $1,778.28 |
Florida Blue Setting Facility Modifier None Typical Low $10,471.29 Median $22,387.21 Typical High $33,884.42 | Facility | None | $10,471.29 | $22,387.21 | $33,884.42 |
Florida Blue Setting Professional Modifier None Typical Low $588.84 Median $630.96 Typical High $933.25 | Professional | None | $588.84 | $630.96 | $933.25 |
Molina Setting Professional Modifier None Typical Low $104.71 Median $691.83 Typical High $1,380.38 | Professional | None | $104.71 | $691.83 | $1,380.38 |
United Setting Facility Modifier None Typical Low $954.99 Median $2,344.23 Typical High $10,232.93 | Facility | None | $954.99 | $2,344.23 | $10,232.93 |
United Setting Professional Modifier None Typical Low $60.26 Median $1,023.29 Typical High $1,949.84 | Professional | None | $60.26 | $1,023.29 | $1,949.84 |
Wellpoint Setting Professional Modifier None Typical Low $794.33 Median $794.33 Typical High $831.76 | Professional | None | $794.33 | $794.33 | $831.76 |
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 $407.38 Typical High $489.78 | Professional | 52 · Reduced service | $380.19 | $407.38 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $162.18 Typical High $194.98 | Professional | 53 · Discontinued | $154.88 | $162.18 | $194.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $602.56 Typical High $741.31 | Professional | 54 · Surgery only | $575.44 | $602.56 | $741.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $120.23 Typical High $147.91 | Professional | 55 · Aftercare only | $114.82 | $120.23 | $147.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $81.28 Typical High $97.72 | Professional | 56 · Pre-op care only | $75.86 | $81.28 | $97.72 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $562.34 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $537.03 | $562.34 | $691.83 |
Where Florida sits
The same service costs 6.3 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· 49th of 51
$832
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.