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 $645.65 Median $5,495.41 Typical High $12,302.69 | Facility | None | $645.65 | $5,495.41 | $12,302.69 |
Aetna Setting Professional Modifier None Typical Low $588.84 Median $630.96 Typical High $758.58 | Professional | None | $588.84 | $630.96 | $758.58 |
AvMed Setting Facility Modifier None Typical Low $575.44 Median $3,467.37 Typical High $11,748.98 | Facility | None | $575.44 | $3,467.37 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $549.54 Median $724.44 Typical High $831.76 | Professional | None | $549.54 | $724.44 | $831.76 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $3,548.13 Typical High $6,606.93 | Facility | None | $512.86 | $3,548.13 | $6,606.93 |
Cigna Setting Professional Modifier None Typical Low $512.86 Median $537.03 Typical High $1,096.48 | Professional | None | $512.86 | $537.03 | $1,096.48 |
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 $302.00 Median $645.65 Typical High $912.01 | Professional | None | $302.00 | $645.65 | $912.01 |
Molina Setting Professional Modifier None Typical Low $60.26 Median $416.87 Typical High $776.25 | Professional | None | $60.26 | $416.87 | $776.25 |
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 $478.63 Median $616.60 Typical High $1,174.90 | Professional | None | $478.63 | $616.60 | $1,174.90 |
Wellpoint Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $676.08 | Professional | None | $512.86 | $512.86 | $676.08 |
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 $295.12 Median $316.23 Typical High $380.19 | Professional | 52 · Reduced service | $295.12 | $316.23 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $117.49 Median $125.89 Typical High $151.36 | Professional | 53 · Discontinued | $117.49 | $125.89 | $151.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $446.68 Median $467.74 Typical High $562.34 | Professional | 54 · Surgery only | $446.68 | $467.74 | $562.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $93.33 Typical High $112.20 | Professional | 55 · Aftercare only | $89.13 | $93.33 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $58.88 Median $63.10 Typical High $75.86 | Professional | 56 · Pre-op care only | $58.88 | $63.10 | $75.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $416.87 Median $436.52 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $416.87 | $436.52 | $524.81 |
Where Florida sits
The same service costs 8.7 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
$589
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.