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 $3,801.89 Typical High $12,022.64 | Facility | None | $776.25 | $3,801.89 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $1,023.29 Median $1,174.90 Typical High $1,412.54 | Professional | None | $1,023.29 | $1,174.90 | $1,412.54 |
AvMed Setting Facility Modifier None Typical Low $1,071.52 Median $2,137.96 Typical High $11,748.98 | Facility | None | $1,071.52 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $1,122.02 Median $1,318.26 Typical High $1,584.89 | Professional | None | $1,122.02 | $1,318.26 | $1,584.89 |
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 $933.25 Median $1,258.93 Typical High $2,511.89 | Professional | None | $933.25 | $1,258.93 | $2,511.89 |
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 $933.25 Median $1,000.00 Typical High $1,318.26 | Professional | None | $933.25 | $1,000.00 | $1,318.26 |
Molina Setting Professional Modifier None Typical Low $186.21 Median $1,122.02 Typical High $2,187.76 | Professional | None | $186.21 | $1,122.02 | $2,187.76 |
United Setting Facility Modifier None Typical Low $398.11 Median $1,000.00 Typical High $5,623.41 | Facility | None | $398.11 | $1,000.00 | $5,623.41 |
United Setting Professional Modifier None Typical Low $60.26 Median $1,380.38 Typical High $2,691.53 | Professional | None | $60.26 | $1,380.38 | $2,691.53 |
Wellpoint Setting Professional Modifier None Typical Low $954.99 Median $954.99 Typical High $1,318.26 | Professional | None | $954.99 | $954.99 | $1,318.26 |
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 $512.86 Median $575.44 Typical High $691.83 | Professional | 52 · Reduced service | $512.86 | $575.44 | $691.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $204.17 Median $234.42 Typical High $275.42 | Professional | 53 · Discontinued | $204.17 | $234.42 | $275.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $870.96 Typical High $1,023.29 | Professional | 54 · Surgery only | $776.25 | $870.96 | $1,023.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $173.78 Typical High $204.17 | Professional | 55 · Aftercare only | $154.88 | $173.78 | $204.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $117.49 Typical High $138.04 | Professional | 56 · Pre-op care only | $102.33 | $117.49 | $138.04 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $812.83 Typical High $954.99 | Professional | 78 · Unplanned return to OR | $724.44 | $812.83 | $954.99 |
Where Florida sits
The same service costs 5.6 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· 47th of 51
$1,202
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.