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 $758.58 Median $3,890.45 Typical High $12,022.64 | Facility | None | $758.58 | $3,890.45 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $758.58 Median $812.83 Typical High $1,023.29 | Professional | None | $758.58 | $812.83 | $1,023.29 |
AvMed Setting Facility Modifier None Typical Low $691.83 Median $2,137.96 Typical High $11,748.98 | Facility | None | $691.83 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $741.31 Median $933.25 Typical High $1,122.02 | Professional | None | $741.31 | $933.25 | $1,122.02 |
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 $676.08 Median $912.01 Typical High $1,778.28 | Professional | None | $676.08 | $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 $616.60 Median $660.69 Typical High $954.99 | Professional | None | $616.60 | $660.69 | $954.99 |
Molina Setting Professional Modifier None Typical Low $144.54 Median $549.54 Typical High $1,174.90 | Professional | None | $144.54 | $549.54 | $1,174.90 |
United Setting Facility Modifier None Typical Low $371.54 Median $954.99 Typical High $7,585.78 | Facility | None | $371.54 | $954.99 | $7,585.78 |
United Setting Professional Modifier None Typical Low $60.26 Median $1,000.00 Typical High $1,949.84 | Professional | None | $60.26 | $1,000.00 | $1,949.84 |
Wellpoint Setting Professional Modifier None Typical Low $630.96 Median $630.96 Typical High $870.96 | Professional | None | $630.96 | $630.96 | $870.96 |
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 $398.11 Typical High $478.63 | Professional | 52 · Reduced service | $380.19 | $398.11 | $478.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $162.18 Typical High $190.55 | Professional | 53 · Discontinued | $151.36 | $162.18 | $190.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $602.56 Typical High $707.95 | Professional | 54 · Surgery only | $575.44 | $602.56 | $707.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $120.23 Typical High $144.54 | Professional | 55 · Aftercare only | $114.82 | $120.23 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $79.43 Typical High $95.50 | Professional | 56 · Pre-op care only | $75.86 | $79.43 | $95.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $562.34 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $537.03 | $562.34 | $660.69 |
Where Florida sits
The same service costs 6.6 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
$724
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.