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 $602.56 Median $616.60 Typical High $812.83 | Professional | None | $602.56 | $616.60 | $812.83 |
AvMed Setting Facility Modifier None Typical Low $549.54 Median $2,137.96 Typical High $11,748.98 | Facility | None | $549.54 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $549.54 Median $691.83 Typical High $851.14 | Professional | None | $549.54 | $691.83 | $851.14 |
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 $524.81 Median $707.95 Typical High $1,380.38 | Professional | None | $524.81 | $707.95 | $1,380.38 |
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 $457.09 Median $489.78 Typical High $758.58 | Professional | None | $457.09 | $489.78 | $758.58 |
Molina Setting Professional Modifier None Typical Low $72.44 Median $501.19 Typical High $1,047.13 | Professional | None | $72.44 | $501.19 | $1,047.13 |
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 $794.33 Typical High $1,513.56 | Professional | None | $60.26 | $794.33 | $1,513.56 |
Wellpoint Setting Professional Modifier None Typical Low $489.78 Median $489.78 Typical High $660.69 | Professional | None | $489.78 | $489.78 | $660.69 |
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 $302.00 Median $302.00 Typical High $380.19 | Professional | 52 · Reduced service | $302.00 | $302.00 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $120.23 Typical High $154.88 | Professional | 53 · Discontinued | $120.23 | $120.23 | $154.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $457.09 Typical High $575.44 | Professional | 54 · Surgery only | $457.09 | $457.09 | $575.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $91.20 Typical High $114.82 | Professional | 55 · Aftercare only | $91.20 | $91.20 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $60.26 Typical High $77.62 | Professional | 56 · Pre-op care only | $60.26 | $60.26 | $77.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $426.58 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $426.58 | $426.58 | $537.03 |
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· 48th of 51
$617
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.