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 $144.54 Median $190.55 Typical High $263.03 | Professional | None | $144.54 | $190.55 | $263.03 |
AvMed Setting Facility Modifier None Typical Low $154.88 Median $2,137.96 Typical High $11,748.98 | Facility | None | $154.88 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $147.91 Median $199.53 Typical High $257.04 | Professional | None | $147.91 | $199.53 | $257.04 |
Cigna Setting Facility Modifier None Typical Low $144.54 Median $288.40 Typical High $1,659.59 | Facility | None | $144.54 | $288.40 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $123.03 Median $177.83 Typical High $288.40 | Professional | None | $123.03 | $177.83 | $288.40 |
Florida Blue Setting Facility Modifier None Typical Low $114.82 Median $251.19 Typical High $3,981.07 | Facility | None | $114.82 | $251.19 | $3,981.07 |
Florida Blue Setting Professional Modifier None Typical Low $165.96 Median $186.21 Typical High $263.03 | Professional | None | $165.96 | $186.21 | $263.03 |
Molina Setting Professional Modifier None Typical Low $134.90 Median $194.98 Typical High $288.40 | Professional | None | $134.90 | $194.98 | $288.40 |
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 $109.65 Median $177.83 Typical High $316.23 | Professional | None | $109.65 | $177.83 | $316.23 |
Wellpoint Setting Professional Modifier None Typical Low $117.49 Median $186.21 Typical High $186.21 | Professional | None | $117.49 | $186.21 | $186.21 |
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 $72.44 Median $95.50 Typical High $104.71 | Professional | 52 · Reduced service | $72.44 | $95.50 | $104.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.84 Median $38.02 Typical High $42.66 | Professional | 53 · Discontinued | $28.84 | $38.02 | $42.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $109.65 Median $144.54 Typical High $158.49 | Professional | 54 · Surgery only | $109.65 | $144.54 | $158.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $28.84 Typical High $31.62 | Professional | 55 · Aftercare only | $21.88 | $28.84 | $31.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $19.05 Typical High $20.89 | Professional | 56 · Pre-op care only | $14.45 | $19.05 | $20.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $102.33 Median $134.90 Typical High $147.91 | Professional | 78 · Unplanned return to OR | $102.33 | $134.90 | $147.91 |
Where Florida sits
The same service costs 3.5 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· 49th of 51
$191
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.