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 $630.96 Median $4,265.80 Typical High $11,748.98 | Facility | None | $630.96 | $4,265.80 | $11,748.98 |
Aetna Setting Professional Modifier None Typical Low $549.54 Median $616.60 Typical High $741.31 | Professional | None | $549.54 | $616.60 | $741.31 |
AvMed Setting Facility Modifier None Typical Low $512.86 Median $1,905.46 Typical High $9,772.37 | Facility | None | $512.86 | $1,905.46 | $9,772.37 |
AvMed Setting Professional Modifier None Typical Low $512.86 Median $676.08 Typical High $758.58 | Professional | None | $512.86 | $676.08 | $758.58 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $776.25 Typical High $2,691.53 | Facility | None | $501.19 | $776.25 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $478.63 Median $676.08 Typical High $1,258.93 | Professional | None | $478.63 | $676.08 | $1,258.93 |
Florida Blue Setting Facility Modifier None Typical Low $1,659.59 Median $3,235.94 Typical High $6,606.93 | Facility | None | $1,659.59 | $3,235.94 | $6,606.93 |
Florida Blue Setting Professional Modifier None Typical Low $426.58 Median $457.09 Typical High $676.08 | Professional | None | $426.58 | $457.09 | $676.08 |
Molina Setting Professional Modifier None Typical Low $69.18 Median $512.86 Typical High $1,096.48 | Professional | None | $69.18 | $512.86 | $1,096.48 |
United Setting Facility Modifier None Typical Low $398.11 Median $1,000.00 Typical High $5,623.41 | Facility | None | $398.11 | $1,000.00 | $5,623.41 |
United Setting Professional Modifier None Typical Low $60.26 Median $724.44 Typical High $1,380.38 | Professional | None | $60.26 | $724.44 | $1,380.38 |
Wellpoint Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $602.56 | Professional | None | $467.74 | $467.74 | $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 $275.42 Median $309.03 Typical High $363.08 | Professional | 52 · Reduced service | $275.42 | $309.03 | $363.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $123.03 Typical High $144.54 | Professional | 53 · Discontinued | $109.65 | $123.03 | $144.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $416.87 Median $467.74 Typical High $537.03 | Professional | 54 · Surgery only | $416.87 | $467.74 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $93.33 Typical High $107.15 | Professional | 55 · Aftercare only | $83.18 | $93.33 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $61.66 Typical High $72.44 | Professional | 56 · Pre-op care only | $54.95 | $61.66 | $72.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $389.05 Median $436.52 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $389.05 | $436.52 | $501.19 |
Where Florida sits
The same service costs 5.9 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· 45th of 51
$692
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.