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 $354.81 Median $3,019.95 Typical High $10,964.78 | Facility | None | $354.81 | $3,019.95 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $79.43 Median $114.82 Typical High $165.96 | Professional | None | $79.43 | $114.82 | $165.96 |
AvMed Setting Facility Modifier None Typical Low $97.72 Median $2,137.96 Typical High $11,748.98 | Facility | None | $97.72 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $85.11 Median $120.23 Typical High $158.49 | Professional | None | $85.11 | $120.23 | $158.49 |
Cigna Setting Facility Modifier None Typical Low $52.48 Median $109.65 Typical High $208.93 | Facility | None | $52.48 | $109.65 | $208.93 |
Cigna Setting Professional Modifier None Typical Low $70.79 Median $104.71 Typical High $169.82 | Professional | None | $70.79 | $104.71 | $169.82 |
Florida Blue Setting Facility Modifier None Typical Low $60.26 Median $131.83 Typical High $3,019.95 | Facility | None | $60.26 | $131.83 | $3,019.95 |
Florida Blue Setting Professional Modifier None Typical Low $102.33 Median $109.65 Typical High $162.18 | Professional | None | $102.33 | $109.65 | $162.18 |
Molina Setting Professional Modifier None Typical Low $75.86 Median $114.82 Typical High $169.82 | Professional | None | $75.86 | $114.82 | $169.82 |
United Setting Facility Modifier None Typical Low $81.28 Median $302.00 Typical High $2,818.38 | Facility | None | $81.28 | $302.00 | $2,818.38 |
United Setting Professional Modifier None Typical Low $61.66 Median $104.71 Typical High $186.21 | Professional | None | $61.66 | $104.71 | $186.21 |
Wellpoint Setting Professional Modifier None Typical Low $67.61 Median $114.82 Typical High $114.82 | Professional | None | $67.61 | $114.82 | $114.82 |
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 $39.81 Median $57.54 Typical High $64.57 | Professional | 52 · Reduced service | $39.81 | $57.54 | $64.57 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.22 Median $22.91 Typical High $25.70 | Professional | 53 · Discontinued | $16.22 | $22.91 | $25.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $60.26 Median $85.11 Typical High $95.50 | Professional | 54 · Surgery only | $60.26 | $85.11 | $95.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $17.38 Typical High $19.50 | Professional | 55 · Aftercare only | $12.02 | $17.38 | $19.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $11.48 Typical High $12.88 | Professional | 56 · Pre-op care only | $7.94 | $11.48 | $12.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $56.23 Median $79.43 Typical High $89.13 | Professional | 78 · Unplanned return to OR | $56.23 | $79.43 | $89.13 |
Where Florida sits
The same service costs 3.5 times more in Alaska than in Kentucky. 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· 50th of 51
$115
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.