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 $5,495.41 Typical High $12,022.64 | Facility | None | $776.25 | $5,495.41 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $831.76 Median $912.01 Typical High $1,174.90 | Professional | None | $831.76 | $912.01 | $1,174.90 |
AvMed Setting Facility Modifier None Typical Low $891.25 Median $2,137.96 Typical High $11,748.98 | Facility | None | $891.25 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $831.76 Median $1,096.48 Typical High $1,348.96 | Professional | None | $831.76 | $1,096.48 | $1,348.96 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $1,737.80 Typical High $2,884.03 | Facility | None | $501.19 | $1,737.80 | $2,884.03 |
Cigna Setting Professional Modifier None Typical Low $794.33 Median $1,023.29 Typical High $2,041.74 | Professional | None | $794.33 | $1,023.29 | $2,041.74 |
Florida Blue Setting Facility Modifier None Typical Low $123.03 Median $263.03 Typical High $16,982.44 | Facility | None | $123.03 | $263.03 | $16,982.44 |
Florida Blue Setting Professional Modifier None Typical Low $741.31 Median $776.25 Typical High $1,071.52 | Professional | None | $741.31 | $776.25 | $1,071.52 |
Molina Setting Professional Modifier None Typical Low $123.03 Median $812.83 Typical High $1,698.24 | Professional | None | $123.03 | $812.83 | $1,698.24 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $3,311.31 Typical High $12,589.25 | Facility | None | $1,230.27 | $3,311.31 | $12,589.25 |
United Setting Professional Modifier None Typical Low $60.26 Median $1,122.02 Typical High $2,290.87 | Professional | None | $60.26 | $1,122.02 | $2,290.87 |
Wellpoint Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $1,122.02 | Professional | None | $812.83 | $812.83 | $1,122.02 |
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 $416.87 Median $457.09 Typical High $588.84 | Professional | 52 · Reduced service | $416.87 | $457.09 | $588.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $181.97 Typical High $234.42 | Professional | 53 · Discontinued | $165.96 | $181.97 | $234.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $676.08 Typical High $870.96 | Professional | 54 · Surgery only | $616.60 | $676.08 | $870.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $138.04 Typical High $173.78 | Professional | 55 · Aftercare only | $123.03 | $138.04 | $173.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $91.20 Typical High $117.49 | Professional | 56 · Pre-op care only | $83.18 | $91.20 | $117.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $630.96 Typical High $812.83 | Professional | 78 · Unplanned return to OR | $575.44 | $630.96 | $812.83 |
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· 47th of 51
$912
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.