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 $741.31 Median $4,786.30 Typical High $11,748.98 | Facility | None | $741.31 | $4,786.30 | $11,748.98 |
Aetna Setting Professional Modifier None Typical Low $741.31 Median $812.83 Typical High $977.24 | Professional | None | $741.31 | $812.83 | $977.24 |
AvMed Setting Facility Modifier None Typical Low $501.19 Median $1,445.44 Typical High $9,549.93 | Facility | None | $501.19 | $1,445.44 | $9,549.93 |
AvMed Setting Professional Modifier None Typical Low $691.83 Median $891.25 Typical High $1,047.13 | Professional | None | $691.83 | $891.25 | $1,047.13 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $1,445.44 Typical High $2,691.53 | Facility | None | $501.19 | $1,445.44 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $660.69 Median $758.58 Typical High $1,318.26 | Professional | None | $660.69 | $758.58 | $1,318.26 |
Florida Blue Setting Facility Modifier None Typical Low $912.01 Median $1,995.26 Typical High $11,748.98 | Facility | None | $912.01 | $1,995.26 | $11,748.98 |
Florida Blue Setting Professional Modifier None Typical Low $602.56 Median $691.83 Typical High $1,000.00 | Professional | None | $602.56 | $691.83 | $1,000.00 |
Molina Setting Professional Modifier None Typical Low $72.44 Median $645.65 Typical High $977.24 | Professional | None | $72.44 | $645.65 | $977.24 |
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 $524.81 Median $794.33 Typical High $1,445.44 | Professional | None | $524.81 | $794.33 | $1,445.44 |
Wellpoint Setting Professional Modifier None Typical Low $660.69 Median $660.69 Typical High $870.96 | Professional | None | $660.69 | $660.69 | $870.96 |
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 $407.38 Typical High $426.58 | Professional | 52 · Reduced service | $371.54 | $407.38 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $162.18 Typical High $169.82 | Professional | 53 · Discontinued | $147.91 | $162.18 | $169.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $602.56 Typical High $630.96 | Professional | 54 · Surgery only | $549.54 | $602.56 | $630.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $120.23 Typical High $128.82 | Professional | 55 · Aftercare only | $109.65 | $120.23 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $81.28 Typical High $85.11 | Professional | 56 · Pre-op care only | $74.13 | $81.28 | $85.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $562.34 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $512.86 | $562.34 | $588.84 |
Where Florida sits
The same service costs 7.1 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· 45th of 51
$912
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.