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 $4,786.30 Typical High $11,748.98 | Facility | None | $776.25 | $4,786.30 | $11,748.98 |
Aetna Setting Professional Modifier None Typical Low $1,096.48 Median $1,202.26 Typical High $1,513.56 | Professional | None | $1,096.48 | $1,202.26 | $1,513.56 |
AvMed Setting Facility Modifier None Typical Low $912.01 Median $2,137.96 Typical High $9,772.37 | Facility | None | $912.01 | $2,137.96 | $9,772.37 |
AvMed Setting Professional Modifier None Typical Low $1,000.00 Median $1,318.26 Typical High $1,548.82 | Professional | None | $1,000.00 | $1,318.26 | $1,548.82 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $3,890.45 Typical High $7,413.10 | Facility | None | $501.19 | $3,890.45 | $7,413.10 |
Cigna Setting Professional Modifier None Typical Low $954.99 Median $1,023.29 Typical High $2,089.30 | Professional | None | $954.99 | $1,023.29 | $2,089.30 |
Florida Blue Setting Facility Modifier None Typical Low $1,318.26 Median $2,630.27 Typical High $16,982.44 | Facility | None | $1,318.26 | $2,630.27 | $16,982.44 |
Florida Blue Setting Professional Modifier None Typical Low $562.34 Median $1,148.15 Typical High $1,380.38 | Professional | None | $562.34 | $1,148.15 | $1,380.38 |
Molina Setting Professional Modifier None Typical Low $91.20 Median $870.96 Typical High $1,479.11 | Professional | None | $91.20 | $870.96 | $1,479.11 |
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 $870.96 Median $1,148.15 Typical High $2,290.87 | Professional | None | $870.96 | $1,148.15 | $2,290.87 |
Wellpoint Setting Professional Modifier None Typical Low $933.25 Median $933.25 Typical High $1,258.93 | Professional | None | $933.25 | $933.25 | $1,258.93 |
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 $549.54 Median $602.56 Typical High $758.58 | Professional | 52 · Reduced service | $549.54 | $602.56 | $758.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $218.78 Median $239.88 Typical High $302.00 | Professional | 53 · Discontinued | $218.78 | $239.88 | $302.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $912.01 Typical High $1,122.02 | Professional | 54 · Surgery only | $812.83 | $912.01 | $1,122.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $181.97 Typical High $223.87 | Professional | 55 · Aftercare only | $162.18 | $181.97 | $223.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $120.23 Typical High $151.36 | Professional | 56 · Pre-op care only | $109.65 | $120.23 | $151.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $851.14 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $758.58 | $851.14 | $1,047.13 |
Where Florida sits
The same service costs 11.0 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
$1,096
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.