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 $630.96 Median $4,786.30 Typical High $11,748.98 | Facility | None | $630.96 | $4,786.30 | $11,748.98 |
Aetna Setting Professional Modifier None Typical Low $338.84 Median $346.74 Typical High $478.63 | Professional | None | $338.84 | $346.74 | $478.63 |
AvMed Setting Facility Modifier None Typical Low $398.11 Median $2,137.96 Typical High $11,748.98 | Facility | None | $398.11 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $331.13 Median $416.87 Typical High $478.63 | Professional | None | $331.13 | $416.87 | $478.63 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $2,041.74 Typical High $3,388.44 | Facility | None | $501.19 | $2,041.74 | $3,388.44 |
Cigna Setting Professional Modifier None Typical Low $309.03 Median $416.87 Typical High $812.83 | Professional | None | $309.03 | $416.87 | $812.83 |
Florida Blue Setting Facility Modifier None Typical Low $1,230.27 Median $2,691.53 Typical High $16,982.44 | Facility | None | $1,230.27 | $2,691.53 | $16,982.44 |
Florida Blue Setting Professional Modifier None Typical Low $275.42 Median $295.12 Typical High $426.58 | Professional | None | $275.42 | $295.12 | $426.58 |
Molina Setting Professional Modifier None Typical Low $51.29 Median $295.12 Typical High $630.96 | Professional | None | $51.29 | $295.12 | $630.96 |
United Setting Facility Modifier None Typical Low $794.33 Median $1,778.28 Typical High $7,585.78 | Facility | None | $794.33 | $1,778.28 | $7,585.78 |
United Setting Professional Modifier None Typical Low $60.26 Median $457.09 Typical High $891.25 | Professional | None | $60.26 | $457.09 | $891.25 |
Wellpoint Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $398.11 | Professional | None | $295.12 | $295.12 | $398.11 |
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 $169.82 Median $173.78 Typical High $229.09 | Professional | 52 · Reduced service | $169.82 | $173.78 | $229.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $69.18 Typical High $91.20 | Professional | 53 · Discontinued | $67.61 | $69.18 | $91.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $257.04 Median $263.03 Typical High $338.84 | Professional | 54 · Surgery only | $257.04 | $263.03 | $338.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $51.29 Median $52.48 Typical High $67.61 | Professional | 55 · Aftercare only | $51.29 | $52.48 | $67.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $34.67 Typical High $45.71 | Professional | 56 · Pre-op care only | $33.88 | $34.67 | $45.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $239.88 Median $245.47 Typical High $316.23 | Professional | 78 · Unplanned return to OR | $239.88 | $245.47 | $316.23 |
Where Florida sits
The same service costs 10.2 times more in Oklahoma 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
$468
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.