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 $660.69 Median $4,073.80 Typical High $11,481.54 | Facility | None | $660.69 | $4,073.80 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $660.69 Median $776.25 Typical High $1,230.27 | Professional | None | $660.69 | $776.25 | $1,230.27 |
AvMed Setting Facility Modifier None Typical Low $512.86 Median $1,584.89 Typical High $9,549.93 | Facility | None | $512.86 | $1,584.89 | $9,549.93 |
AvMed Setting Professional Modifier None Typical Low $812.83 Median $1,122.02 Typical High $1,412.54 | Professional | None | $812.83 | $1,122.02 | $1,412.54 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $1,148.15 Typical High $3,311.31 | Facility | None | $588.84 | $1,148.15 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $812.83 Median $912.01 Typical High $1,659.59 | Professional | None | $812.83 | $912.01 | $1,659.59 |
Florida Blue Setting Facility Modifier None Typical Low $741.31 Median $1,621.81 Typical High $7,413.10 | Facility | None | $741.31 | $1,621.81 | $7,413.10 |
Florida Blue Setting Professional Modifier None Typical Low $331.13 Median $851.14 Typical High $1,258.93 | Professional | None | $331.13 | $851.14 | $1,258.93 |
Molina Setting Professional Modifier None Typical Low $138.04 Median $912.01 Typical High $1,513.56 | Professional | None | $138.04 | $912.01 | $1,513.56 |
United Setting Facility Modifier None Typical Low $794.33 Median $1,778.28 Typical High $7,585.78 | Facility | None | $794.33 | $1,778.28 | $7,585.78 |
United Setting Professional Modifier None Typical Low $630.96 Median $891.25 Typical High $1,819.70 | Professional | None | $630.96 | $891.25 | $1,819.70 |
Wellpoint Setting Professional Modifier None Typical Low $724.44 Median $724.44 Typical High $1,174.90 | Professional | None | $724.44 | $724.44 | $1,174.90 |
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 $331.13 Median $389.05 Typical High $602.56 | Professional | 52 · Reduced service | $331.13 | $389.05 | $602.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $154.88 Typical High $239.88 | Professional | 53 · Discontinued | $131.83 | $154.88 | $239.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $588.84 Typical High $912.01 | Professional | 54 · Surgery only | $501.19 | $588.84 | $912.01 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $117.49 Typical High $181.97 | Professional | 55 · Aftercare only | $100.00 | $117.49 | $181.97 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $77.62 Typical High $120.23 | Professional | 56 · Pre-op care only | $66.07 | $77.62 | $120.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $467.74 Median $549.54 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $467.74 | $549.54 | $851.14 |
Where Florida sits
The same service costs 5.9 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
$955
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.