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 $12,022.64 | Facility | None | $776.25 | $6,025.60 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $478.63 Median $501.19 Typical High $724.44 | Professional | None | $478.63 | $501.19 | $724.44 |
AvMed Setting Facility Modifier None Typical Low $549.54 Median $2,137.96 Typical High $9,772.37 | Facility | None | $549.54 | $2,137.96 | $9,772.37 |
AvMed Setting Professional Modifier None Typical Low $416.87 Median $549.54 Typical High $602.56 | Professional | None | $416.87 | $549.54 | $602.56 |
Cigna Setting Facility Modifier None Typical Low $616.60 Median $2,041.74 Typical High $3,311.31 | Facility | None | $616.60 | $2,041.74 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $446.68 Median $457.09 Typical High $977.24 | Professional | None | $446.68 | $457.09 | $977.24 |
Florida Blue Setting Facility Modifier None Typical Low $1,230.27 Median $2,630.27 Typical High $16,982.44 | Facility | None | $1,230.27 | $2,630.27 | $16,982.44 |
Florida Blue Setting Professional Modifier None Typical Low $281.84 Median $426.58 Typical High $660.69 | Professional | None | $281.84 | $426.58 | $660.69 |
Molina Setting Professional Modifier None Typical Low $67.61 Median $371.54 Typical High $691.83 | Professional | None | $67.61 | $371.54 | $691.83 |
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 $380.19 Median $537.03 Typical High $954.99 | Professional | None | $380.19 | $537.03 | $954.99 |
Wellpoint Setting Professional Modifier None Typical Low $436.52 Median $602.56 Typical High $602.56 | Professional | None | $436.52 | $602.56 | $602.56 |
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 $239.88 Median $251.19 Typical High $346.74 | Professional | 52 · Reduced service | $239.88 | $251.19 | $346.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $100.00 Typical High $138.04 | Professional | 53 · Discontinued | $95.50 | $100.00 | $138.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $380.19 Typical High $524.81 | Professional | 54 · Surgery only | $363.08 | $380.19 | $524.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $75.86 Typical High $104.71 | Professional | 55 · Aftercare only | $72.44 | $75.86 | $104.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $50.12 Typical High $69.18 | Professional | 56 · Pre-op care only | $47.86 | $50.12 | $69.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $354.81 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $338.84 | $354.81 | $489.78 |
Where Florida sits
The same service costs 8.5 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· 47th of 51
$603
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.