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 $602.56 Median $3,090.30 Typical High $10,964.78 | Facility | None | $602.56 | $3,090.30 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $501.19 Median $616.60 Typical High $891.25 | Professional | None | $501.19 | $616.60 | $891.25 |
Ambetter Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $776.25 | Professional | None | $354.81 | $354.81 | $776.25 |
AvMed Setting Facility Modifier None Typical Low $549.54 Median $1,479.11 Typical High $9,549.93 | Facility | None | $549.54 | $1,479.11 | $9,549.93 |
AvMed Setting Professional Modifier None Typical Low $575.44 Median $676.08 Typical High $851.14 | Professional | None | $575.44 | $676.08 | $851.14 |
Cigna Setting Facility Modifier None Typical Low $436.52 Median $1,318.26 Typical High $2,187.76 | Facility | None | $436.52 | $1,318.26 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $457.09 Median $562.34 Typical High $933.25 | Professional | None | $457.09 | $562.34 | $933.25 |
Florida Blue Setting Facility Modifier None Typical Low $660.69 Median $1,659.59 Typical High $8,511.38 | Facility | None | $660.69 | $1,659.59 | $8,511.38 |
Florida Blue Setting Professional Modifier None Typical Low $549.54 Median $616.60 Typical High $870.96 | Professional | None | $549.54 | $616.60 | $870.96 |
Molina Setting Professional Modifier None Typical Low $75.86 Median $588.84 Typical High $912.01 | Professional | None | $75.86 | $588.84 | $912.01 |
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 $398.11 Median $588.84 Typical High $1,047.13 | Professional | None | $398.11 | $588.84 | $1,047.13 |
Wellpoint Setting Professional Modifier None Typical Low $426.58 Median $602.56 Typical High $602.56 | Professional | None | $426.58 | $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 $251.19 Median $302.00 Typical High $331.13 | Professional | 52 · Reduced service | $251.19 | $302.00 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $120.23 Typical High $131.83 | Professional | 53 · Discontinued | $100.00 | $120.23 | $131.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $446.68 Typical High $501.19 | Professional | 54 · Surgery only | $371.54 | $446.68 | $501.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $89.13 Typical High $100.00 | Professional | 55 · Aftercare only | $74.13 | $89.13 | $100.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $60.26 Typical High $66.07 | Professional | 56 · Pre-op care only | $50.12 | $60.26 | $66.07 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $346.74 Median $416.87 Typical High $467.74 | Professional | 78 · Unplanned return to OR | $346.74 | $416.87 | $467.74 |
Where Florida sits
The same service costs 4.2 times more in Alaska than in Texas. 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
$661
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.