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 $12,022.64 | Facility | None | $776.25 | $6,025.60 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $691.83 Median $724.44 Typical High $891.25 | Professional | None | $691.83 | $724.44 | $891.25 |
AvMed Setting Facility Modifier None Typical Low $630.96 Median $2,137.96 Typical High $11,748.98 | Facility | None | $630.96 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $676.08 Median $851.14 Typical High $1,023.29 | Professional | None | $676.08 | $851.14 | $1,023.29 |
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 $616.60 Median $831.76 Typical High $1,584.89 | Professional | None | $616.60 | $831.76 | $1,584.89 |
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 $549.54 Median $588.84 Typical High $870.96 | Professional | None | $549.54 | $588.84 | $870.96 |
Molina Setting Professional Modifier None Typical Low $144.54 Median $467.74 Typical High $1,047.13 | Professional | None | $144.54 | $467.74 | $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 $912.01 Typical High $1,737.80 | Professional | None | $60.26 | $912.01 | $1,737.80 |
Wellpoint Setting Professional Modifier None Typical Low $575.44 Median $575.44 Typical High $794.33 | Professional | None | $575.44 | $575.44 | $794.33 |
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 $346.74 Median $363.08 Typical High $426.58 | Professional | 52 · Reduced service | $346.74 | $363.08 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $144.54 Typical High $173.78 | Professional | 53 · Discontinued | $138.04 | $144.54 | $173.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $549.54 Typical High $645.65 | Professional | 54 · Surgery only | $512.86 | $549.54 | $645.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $109.65 Typical High $128.82 | Professional | 55 · Aftercare only | $104.71 | $109.65 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $72.44 Typical High $87.10 | Professional | 56 · Pre-op care only | $69.18 | $72.44 | $87.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $512.86 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $478.63 | $512.86 | $602.56 |
Where Florida sits
The same service costs 8.5 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
$692
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.