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 $891.25 Median $6,456.54 Typical High $14,791.08 | Facility | None | $891.25 | $6,456.54 | $14,791.08 |
Aetna Setting Professional Modifier None Typical Low $758.58 Median $891.25 Typical High $1,096.48 | Professional | None | $758.58 | $891.25 | $1,096.48 |
AvMed Setting Facility Modifier None Typical Low $776.25 Median $2,818.38 Typical High $11,748.98 | Facility | None | $776.25 | $2,818.38 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $741.31 Median $954.99 Typical High $1,122.02 | Professional | None | $741.31 | $954.99 | $1,122.02 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $2,951.21 Typical High $5,370.32 | Facility | None | $512.86 | $2,951.21 | $5,370.32 |
Cigna Setting Professional Modifier None Typical Low $724.44 Median $758.58 Typical High $1,548.82 | Professional | None | $724.44 | $758.58 | $1,548.82 |
Florida Blue Setting Facility Modifier None Typical Low $1,737.80 Median $3,548.13 Typical High $16,982.44 | Facility | None | $1,737.80 | $3,548.13 | $16,982.44 |
Florida Blue Setting Professional Modifier None Typical Low $389.05 Median $851.14 Typical High $1,000.00 | Professional | None | $389.05 | $851.14 | $1,000.00 |
Molina Setting Professional Modifier None Typical Low $60.26 Median $602.56 Typical High $1,096.48 | Professional | None | $60.26 | $602.56 | $1,096.48 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $3,311.31 Typical High $12,589.25 | Facility | None | $1,230.27 | $3,311.31 | $12,589.25 |
United Setting Professional Modifier None Typical Low $645.65 Median $851.14 Typical High $1,698.24 | Professional | None | $645.65 | $851.14 | $1,698.24 |
Wellpoint Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $933.25 | Professional | None | $691.83 | $691.83 | $933.25 |
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 $380.19 Median $446.68 Typical High $537.03 | Professional | 52 · Reduced service | $380.19 | $446.68 | $537.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $181.97 Typical High $213.80 | Professional | 53 · Discontinued | $154.88 | $181.97 | $213.80 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $676.08 Typical High $794.33 | Professional | 54 · Surgery only | $575.44 | $676.08 | $794.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $134.90 Typical High $158.49 | Professional | 55 · Aftercare only | $114.82 | $134.90 | $158.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $89.13 Typical High $107.15 | Professional | 56 · Pre-op care only | $75.86 | $89.13 | $107.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $630.96 Typical High $741.31 | Professional | 78 · Unplanned return to OR | $537.03 | $630.96 | $741.31 |
Where Florida sits
The same service costs 18.2 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
$794
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.