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 $524.81 Median $3,090.30 Typical High $11,481.54 | Facility | None | $524.81 | $3,090.30 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $478.63 Median $524.81 Typical High $724.44 | Professional | None | $478.63 | $524.81 | $724.44 |
AvMed Setting Facility Modifier None Typical Low $501.19 Median $1,513.56 Typical High $9,549.93 | Facility | None | $501.19 | $1,513.56 | $9,549.93 |
AvMed Setting Professional Modifier None Typical Low $537.03 Median $660.69 Typical High $758.58 | Professional | None | $537.03 | $660.69 | $758.58 |
Cigna Setting Facility Modifier None Typical Low $323.59 Median $1,659.59 Typical High $2,884.03 | Facility | None | $323.59 | $1,659.59 | $2,884.03 |
Cigna Setting Professional Modifier None Typical Low $478.63 Median $512.86 Typical High $954.99 | Professional | None | $478.63 | $512.86 | $954.99 |
Florida Blue Setting Facility Modifier None Typical Low $660.69 Median $1,318.26 Typical High $16,982.44 | Facility | None | $660.69 | $1,318.26 | $16,982.44 |
Florida Blue Setting Professional Modifier None Typical Low $245.47 Median $562.34 Typical High $724.44 | Professional | None | $245.47 | $562.34 | $724.44 |
Molina Setting Professional Modifier None Typical Low $60.26 Median $426.58 Typical High $794.33 | Professional | None | $60.26 | $426.58 | $794.33 |
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 $426.58 Median $537.03 Typical High $1,047.13 | Professional | None | $426.58 | $537.03 | $1,047.13 |
Wellpoint Setting Professional Modifier None Typical Low $489.78 Median $489.78 Typical High $676.08 | Professional | None | $489.78 | $489.78 | $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 $239.88 Median $263.03 Typical High $363.08 | Professional | 52 · Reduced service | $239.88 | $263.03 | $363.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $104.71 Typical High $144.54 | Professional | 53 · Discontinued | $95.50 | $104.71 | $144.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $389.05 Typical High $537.03 | Professional | 54 · Surgery only | $363.08 | $389.05 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $79.43 Typical High $107.15 | Professional | 55 · Aftercare only | $72.44 | $79.43 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $52.48 Typical High $72.44 | Professional | 56 · Pre-op care only | $47.86 | $52.48 | $72.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $363.08 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $338.84 | $363.08 | $501.19 |
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· 49th of 51
$537
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.