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 $630.96 Median $4,786.30 Typical High $12,022.64 | Facility | None | $630.96 | $4,786.30 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $436.52 Median $512.86 Typical High $630.96 | Professional | None | $436.52 | $512.86 | $630.96 |
AvMed Setting Facility Modifier None Typical Low $512.86 Median $2,137.96 Typical High $9,772.37 | Facility | None | $512.86 | $2,137.96 | $9,772.37 |
AvMed Setting Professional Modifier None Typical Low $446.68 Median $562.34 Typical High $645.65 | Professional | None | $446.68 | $562.34 | $645.65 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $4,365.16 Typical High $8,317.64 | Facility | None | $501.19 | $4,365.16 | $8,317.64 |
Cigna Setting Professional Modifier None Typical Low $416.87 Median $446.68 Typical High $870.96 | Professional | None | $416.87 | $446.68 | $870.96 |
Florida Blue Setting Facility Modifier None Typical Low $1,778.28 Median $3,548.13 Typical High $16,982.44 | Facility | None | $1,778.28 | $3,548.13 | $16,982.44 |
Florida Blue Setting Professional Modifier None Typical Low $223.87 Median $512.86 Typical High $645.65 | Professional | None | $223.87 | $512.86 | $645.65 |
Molina Setting Professional Modifier None Typical Low $60.26 Median $346.74 Typical High $676.08 | Professional | None | $60.26 | $346.74 | $676.08 |
United Setting Facility Modifier None Typical Low $1,584.89 Median $4,073.80 Typical High $15,488.17 | Facility | None | $1,584.89 | $4,073.80 | $15,488.17 |
United Setting Professional Modifier None Typical Low $371.54 Median $489.78 Typical High $954.99 | Professional | None | $371.54 | $489.78 | $954.99 |
Wellpoint Setting Professional Modifier None Typical Low $426.58 Median $426.58 Typical High $562.34 | Professional | None | $426.58 | $426.58 | $562.34 |
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 $218.78 Median $251.19 Typical High $302.00 | Professional | 52 · Reduced service | $218.78 | $251.19 | $302.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $102.33 Typical High $123.03 | Professional | 53 · Discontinued | $89.13 | $102.33 | $123.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $331.13 Median $380.19 Typical High $457.09 | Professional | 54 · Surgery only | $331.13 | $380.19 | $457.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $75.86 Typical High $91.20 | Professional | 55 · Aftercare only | $66.07 | $75.86 | $91.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $51.29 Typical High $61.66 | Professional | 56 · Pre-op care only | $43.65 | $51.29 | $61.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $309.03 Median $354.81 Typical High $426.58 | Professional | 78 · Unplanned return to OR | $309.03 | $354.81 | $426.58 |
Where Florida sits
The same service costs 7.8 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
$490
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.