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 $537.03 Median $3,801.89 Typical High $11,748.98 | Facility | None | $537.03 | $3,801.89 | $11,748.98 |
Aetna Setting Professional Modifier None Typical Low $239.88 Median $363.08 Typical High $478.63 | Professional | None | $239.88 | $363.08 | $478.63 |
AvMed Setting Facility Modifier None Typical Low $501.19 Median $1,737.80 Typical High $9,772.37 | Facility | None | $501.19 | $1,737.80 | $9,772.37 |
AvMed Setting Professional Modifier None Typical Low $295.12 Median $436.52 Typical High $575.44 | Professional | None | $295.12 | $436.52 | $575.44 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $776.25 Typical High $2,691.53 | Facility | None | $501.19 | $776.25 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $234.42 Median $354.81 Typical High $588.84 | Professional | None | $234.42 | $354.81 | $588.84 |
Florida Blue Setting Facility Modifier None Typical Low $616.60 Median $1,348.96 Typical High $6,309.57 | Facility | None | $616.60 | $1,348.96 | $6,309.57 |
Florida Blue Setting Professional Modifier None Typical Low $186.21 Median $380.19 Typical High $588.84 | Professional | None | $186.21 | $380.19 | $588.84 |
Molina Setting Professional Modifier None Typical Low $31.62 Median $323.59 Typical High $645.65 | Professional | None | $31.62 | $323.59 | $645.65 |
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 $218.78 Median $363.08 Typical High $707.95 | Professional | None | $218.78 | $363.08 | $707.95 |
Wellpoint Setting Professional Modifier None Typical Low $245.47 Median $416.87 Typical High $416.87 | Professional | None | $245.47 | $416.87 | $416.87 |
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 $120.23 Median $181.97 Typical High $239.88 | Professional | 52 · Reduced service | $120.23 | $181.97 | $239.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $47.86 Median $72.44 Typical High $95.50 | Professional | 53 · Discontinued | $47.86 | $72.44 | $95.50 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $181.97 Median $275.42 Typical High $354.81 | Professional | 54 · Surgery only | $181.97 | $275.42 | $354.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $54.95 Typical High $70.79 | Professional | 55 · Aftercare only | $36.31 | $54.95 | $70.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $36.31 Typical High $47.86 | Professional | 56 · Pre-op care only | $23.99 | $36.31 | $47.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $169.82 Median $257.04 Typical High $331.13 | Professional | 78 · Unplanned return to OR | $169.82 | $257.04 | $331.13 |
Where Florida sits
The same service costs 5.1 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· 48th of 51
$380
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.