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 $776.25 Median $812.83 Typical High $1,148.15 | Professional | None | $776.25 | $812.83 | $1,148.15 |
AvMed Setting Facility Modifier None Typical Low $741.31 Median $2,089.30 Typical High $9,772.37 | Facility | None | $741.31 | $2,089.30 | $9,772.37 |
AvMed Setting Professional Modifier None Typical Low $691.83 Median $912.01 Typical High $1,000.00 | Professional | None | $691.83 | $912.01 | $1,000.00 |
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 $724.44 Median $758.58 Typical High $1,513.56 | Professional | None | $724.44 | $758.58 | $1,513.56 |
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 $436.52 Median $691.83 Typical High $1,071.52 | Professional | None | $436.52 | $691.83 | $1,071.52 |
Molina Setting Professional Modifier None Typical Low $67.61 Median $602.56 Typical High $1,122.02 | Professional | None | $67.61 | $602.56 | $1,122.02 |
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 $575.44 Median $831.76 Typical High $1,513.56 | Professional | None | $575.44 | $831.76 | $1,513.56 |
Wellpoint Setting Professional Modifier None Typical Low $724.44 Median $977.24 Typical High $977.24 | Professional | None | $724.44 | $977.24 | $977.24 |
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 $389.05 Median $407.38 Typical High $575.44 | Professional | 52 · Reduced service | $389.05 | $407.38 | $575.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $162.18 Typical High $229.09 | Professional | 53 · Discontinued | $154.88 | $162.18 | $229.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $616.60 Typical High $870.96 | Professional | 54 · Surgery only | $588.84 | $616.60 | $870.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $123.03 Typical High $173.78 | Professional | 55 · Aftercare only | $117.49 | $123.03 | $173.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $81.28 Typical High $114.82 | Professional | 56 · Pre-op care only | $77.62 | $81.28 | $114.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $575.44 Typical High $812.83 | Professional | 78 · Unplanned return to OR | $549.54 | $575.44 | $812.83 |
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· 46th 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.