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 $676.08 Median $4,786.30 Typical High $11,748.98 | Facility | None | $676.08 | $4,786.30 | $11,748.98 |
Aetna Setting Professional Modifier None Typical Low $676.08 Median $707.95 Typical High $1,023.29 | Professional | None | $676.08 | $707.95 | $1,023.29 |
AvMed Setting Facility Modifier None Typical Low $645.65 Median $2,089.30 Typical High $9,772.37 | Facility | None | $645.65 | $2,089.30 | $9,772.37 |
AvMed Setting Professional Modifier None Typical Low $616.60 Median $758.58 Typical High $891.25 | Professional | None | $616.60 | $758.58 | $891.25 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $1,995.26 Typical High $3,090.30 | Facility | None | $501.19 | $1,995.26 | $3,090.30 |
Cigna Setting Professional Modifier None Typical Low $645.65 Median $676.08 Typical High $1,288.25 | Professional | None | $645.65 | $676.08 | $1,288.25 |
Florida Blue Setting Facility Modifier None Typical Low $1,659.59 Median $3,548.13 Typical High $16,982.44 | Facility | None | $1,659.59 | $3,548.13 | $16,982.44 |
Florida Blue Setting Professional Modifier None Typical Low $331.13 Median $588.84 Typical High $933.25 | Professional | None | $331.13 | $588.84 | $933.25 |
Molina Setting Professional Modifier None Typical Low $67.61 Median $537.03 Typical High $1,023.29 | Professional | None | $67.61 | $537.03 | $1,023.29 |
United Setting Facility Modifier None Typical Low $954.99 Median $2,344.23 Typical High $10,000.00 | Facility | None | $954.99 | $2,344.23 | $10,000.00 |
United Setting Professional Modifier None Typical Low $489.78 Median $707.95 Typical High $1,288.25 | Professional | None | $489.78 | $707.95 | $1,288.25 |
Wellpoint Setting Professional Modifier None Typical Low $645.65 Median $851.14 Typical High $851.14 | Professional | None | $645.65 | $851.14 | $851.14 |
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 $338.84 Median $354.81 Typical High $478.63 | Professional | 52 · Reduced service | $338.84 | $354.81 | $478.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $141.25 Typical High $190.55 | Professional | 53 · Discontinued | $134.90 | $141.25 | $190.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $537.03 Typical High $724.44 | Professional | 54 · Surgery only | $512.86 | $537.03 | $724.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $107.15 Typical High $144.54 | Professional | 55 · Aftercare only | $102.33 | $107.15 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $70.79 Typical High $95.50 | Professional | 56 · Pre-op care only | $67.61 | $70.79 | $95.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $501.19 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $478.63 | $501.19 | $676.08 |
Where Florida sits
The same service costs 8.1 times more in Wyoming than in Utah. 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· 45th of 51
$851
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.