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 $724.44 Median $4,265.80 Typical High $11,748.98 | Facility | None | $724.44 | $4,265.80 | $11,748.98 |
Aetna Setting Professional Modifier None Typical Low $724.44 Median $954.99 Typical High $1,148.15 | Professional | None | $724.44 | $954.99 | $1,148.15 |
Ambetter Setting Professional Modifier None Typical Low $1,949.84 Median $1,949.84 Typical High $1,949.84 | Professional | None | $1,949.84 | $1,949.84 | $1,949.84 |
AvMed Setting Facility Modifier None Typical Low $812.83 Median $2,137.96 Typical High $9,772.37 | Facility | None | $812.83 | $2,137.96 | $9,772.37 |
AvMed Setting Professional Modifier None Typical Low $588.84 Median $1,023.29 Typical High $1,202.26 | Professional | None | $588.84 | $1,023.29 | $1,202.26 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $2,570.40 Typical High $4,168.69 | Facility | None | $501.19 | $2,570.40 | $4,168.69 |
Cigna Setting Professional Modifier None Typical Low $724.44 Median $812.83 Typical High $1,584.89 | Professional | None | $724.44 | $812.83 | $1,584.89 |
Florida Blue Setting Facility Modifier None Typical Low $660.69 Median $1,380.38 Typical High $16,982.44 | Facility | None | $660.69 | $1,380.38 | $16,982.44 |
Florida Blue Setting Professional Modifier None Typical Low $398.11 Median $812.83 Typical High $1,096.48 | Professional | None | $398.11 | $812.83 | $1,096.48 |
Molina Setting Professional Modifier None Typical Low $60.26 Median $630.96 Typical High $1,174.90 | Professional | None | $60.26 | $630.96 | $1,174.90 |
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 $467.74 Median $851.14 Typical High $1,778.28 | Professional | None | $467.74 | $851.14 | $1,778.28 |
Wellpoint Setting Professional Modifier None Typical Low $616.60 Median $616.60 Typical High $1,023.29 | Professional | None | $616.60 | $616.60 | $1,023.29 |
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 $363.08 Median $478.63 Typical High $575.44 | Professional | 52 · Reduced service | $363.08 | $478.63 | $575.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $190.55 Typical High $229.09 | Professional | 53 · Discontinued | $144.54 | $190.55 | $229.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $724.44 Typical High $851.14 | Professional | 54 · Surgery only | $549.54 | $724.44 | $851.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $144.54 Typical High $169.82 | Professional | 55 · Aftercare only | $109.65 | $144.54 | $169.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $95.50 Typical High $114.82 | Professional | 56 · Pre-op care only | $72.44 | $95.50 | $114.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $676.08 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $512.86 | $676.08 | $794.33 |
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
$813
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.