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 $257.04 Median $316.23 Typical High $416.87 | Professional | None | $257.04 | $316.23 | $416.87 |
AvMed Setting Facility Modifier None Typical Low $131.83 Median $954.99 Typical High $9,549.93 | Facility | None | $131.83 | $954.99 | $9,549.93 |
AvMed Setting Professional Modifier None Typical Low $302.00 Median $389.05 Typical High $467.74 | Professional | None | $302.00 | $389.05 | $467.74 |
Cigna Setting Facility Modifier None Typical Low $131.83 Median $281.84 Typical High $1,659.59 | Facility | None | $131.83 | $281.84 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $263.03 Median $302.00 Typical High $549.54 | Professional | None | $263.03 | $302.00 | $549.54 |
Florida Blue Setting Facility Modifier None Typical Low $199.53 Median $436.52 Typical High $3,019.95 | Facility | None | $199.53 | $436.52 | $3,019.95 |
Florida Blue Setting Professional Modifier None Typical Low $138.04 Median $331.13 Typical High $478.63 | Professional | None | $138.04 | $331.13 | $478.63 |
Molina Setting Professional Modifier None Typical Low $31.62 Median $316.23 Typical High $549.54 | Professional | None | $31.62 | $316.23 | $549.54 |
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 $239.88 Median $309.03 Typical High $616.60 | Professional | None | $239.88 | $309.03 | $616.60 |
Wellpoint Setting Professional Modifier None Typical Low $288.40 Median $338.84 Typical High $338.84 | Professional | None | $288.40 | $338.84 | $338.84 |
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 $128.82 Median $154.88 Typical High $208.93 | Professional | 52 · Reduced service | $128.82 | $154.88 | $208.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $51.29 Median $63.10 Typical High $83.18 | Professional | 53 · Discontinued | $51.29 | $63.10 | $83.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $190.55 Median $234.42 Typical High $309.03 | Professional | 54 · Surgery only | $190.55 | $234.42 | $309.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.02 Median $46.77 Typical High $61.66 | Professional | 55 · Aftercare only | $38.02 | $46.77 | $61.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $31.62 Typical High $41.69 | Professional | 56 · Pre-op care only | $25.70 | $31.62 | $41.69 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $177.83 Median $218.78 Typical High $288.40 | Professional | 78 · Unplanned return to OR | $177.83 | $218.78 | $288.40 |
Where Florida sits
The same service costs 5.2 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· 49th of 51
$316
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.