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 $6,025.60 Typical High $12,882.50 | Facility | None | $776.25 | $6,025.60 | $12,882.50 |
Aetna Setting Professional Modifier None Typical Low $741.31 Median $776.25 Typical High $1,096.48 | Professional | None | $741.31 | $776.25 | $1,096.48 |
AvMed Setting Facility Modifier None Typical Low $707.95 Median $2,137.96 Typical High $9,772.37 | Facility | None | $707.95 | $2,137.96 | $9,772.37 |
AvMed Setting Professional Modifier None Typical Low $645.65 Median $851.14 Typical High $912.01 | Professional | None | $645.65 | $851.14 | $912.01 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $1,479.11 Typical High $3,801.89 | Facility | None | $707.95 | $1,479.11 | $3,801.89 |
Cigna Setting Professional Modifier None Typical Low $676.08 Median $707.95 Typical High $1,445.44 | Professional | None | $676.08 | $707.95 | $1,445.44 |
Florida Blue Setting Facility Modifier None Typical Low $123.03 Median $275.42 Typical High $7,413.10 | Facility | None | $123.03 | $275.42 | $7,413.10 |
Florida Blue Setting Professional Modifier None Typical Low $380.19 Median $630.96 Typical High $1,000.00 | Professional | None | $380.19 | $630.96 | $1,000.00 |
Molina Setting Professional Modifier None Typical Low $67.61 Median $575.44 Typical High $1,071.52 | Professional | None | $67.61 | $575.44 | $1,071.52 |
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 $575.44 Median $812.83 Typical High $1,445.44 | Professional | None | $575.44 | $812.83 | $1,445.44 |
Wellpoint Setting Professional Modifier None Typical Low $676.08 Median $912.01 Typical High $912.01 | Professional | None | $676.08 | $912.01 | $912.01 |
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 $371.54 Median $389.05 Typical High $537.03 | Professional | 52 · Reduced service | $371.54 | $389.05 | $537.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $154.88 Typical High $213.80 | Professional | 53 · Discontinued | $147.91 | $154.88 | $213.80 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $575.44 Typical High $812.83 | Professional | 54 · Surgery only | $549.54 | $575.44 | $812.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $114.82 Typical High $162.18 | Professional | 55 · Aftercare only | $109.65 | $114.82 | $162.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $77.62 Typical High $107.15 | Professional | 56 · Pre-op care only | $74.13 | $77.62 | $107.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $537.03 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $512.86 | $537.03 | $758.58 |
Where Florida sits
The same service costs 7.2 times more in Alaska 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· 49th of 51
$741
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.