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 $478.63 Median $3,090.30 Typical High $10,964.78 | Facility | None | $478.63 | $3,090.30 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $257.04 Median $346.74 Typical High $512.86 | Professional | None | $257.04 | $346.74 | $512.86 |
Ambetter Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $512.86 | Professional | None | $512.86 | $512.86 | $512.86 |
AvMed Setting Facility Modifier None Typical Low $446.68 Median $1,479.11 Typical High $9,549.93 | Facility | None | $446.68 | $1,479.11 | $9,549.93 |
AvMed Setting Professional Modifier None Typical Low $309.03 Median $380.19 Typical High $489.78 | Professional | None | $309.03 | $380.19 | $489.78 |
Cigna Setting Facility Modifier None Typical Low $436.52 Median $870.96 Typical High $2,187.76 | Facility | None | $436.52 | $870.96 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $218.78 Median $316.23 Typical High $575.44 | Professional | None | $218.78 | $316.23 | $575.44 |
Florida Blue Setting Facility Modifier None Typical Low $616.60 Median $1,348.96 Typical High $6,309.57 | Facility | None | $616.60 | $1,348.96 | $6,309.57 |
Florida Blue Setting Professional Modifier None Typical Low $177.83 Median $389.05 Typical High $489.78 | Professional | None | $177.83 | $389.05 | $489.78 |
Molina Setting Professional Modifier None Typical Low $31.62 Median $275.42 Typical High $524.81 | Professional | None | $31.62 | $275.42 | $524.81 |
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 $218.78 Median $331.13 Typical High $660.69 | Professional | None | $218.78 | $331.13 | $660.69 |
Wellpoint Setting Professional Modifier None Typical Low $229.09 Median $354.81 Typical High $354.81 | Professional | None | $229.09 | $354.81 | $354.81 |
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 $173.78 Typical High $223.87 | Professional | 52 · Reduced service | $128.82 | $173.78 | $223.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $51.29 Median $70.79 Typical High $89.13 | Professional | 53 · Discontinued | $51.29 | $70.79 | $89.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $194.98 Median $263.03 Typical High $331.13 | Professional | 54 · Surgery only | $194.98 | $263.03 | $331.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $52.48 Typical High $66.07 | Professional | 55 · Aftercare only | $38.90 | $52.48 | $66.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $34.67 Typical High $44.67 | Professional | 56 · Pre-op care only | $25.70 | $34.67 | $44.67 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $181.97 Median $245.47 Typical High $309.03 | Professional | 78 · Unplanned return to OR | $181.97 | $245.47 | $309.03 |
Where Florida sits
The same service costs 4.9 times more in Alaska than in Utah. 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
$347
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.