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 $354.81 Median $3,019.95 Typical High $10,964.78 | Facility | None | $354.81 | $3,019.95 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $77.62 Median $91.20 Typical High $120.23 | Professional | None | $77.62 | $91.20 | $120.23 |
AvMed Setting Facility Modifier None Typical Low $102.33 Median $2,137.96 Typical High $11,748.98 | Facility | None | $102.33 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $97.72 Median $107.15 Typical High $128.82 | Professional | None | $97.72 | $107.15 | $128.82 |
Cigna Setting Facility Modifier None Typical Low $52.48 Median $93.33 Typical High $181.97 | Facility | None | $52.48 | $93.33 | $181.97 |
Cigna Setting Professional Modifier None Typical Low $70.79 Median $85.11 Typical High $162.18 | Professional | None | $70.79 | $85.11 | $162.18 |
Florida Blue Setting Facility Modifier None Typical Low $60.26 Median $131.83 Typical High $3,019.95 | Facility | None | $60.26 | $131.83 | $3,019.95 |
Florida Blue Setting Professional Modifier None Typical Low $42.66 Median $97.72 Typical High $134.90 | Professional | None | $42.66 | $97.72 | $134.90 |
Molina Setting Professional Modifier None Typical Low $27.54 Median $91.20 Typical High $165.96 | Professional | None | $27.54 | $91.20 | $165.96 |
United Setting Facility Modifier None Typical Low $81.28 Median $302.00 Typical High $2,818.38 | Facility | None | $81.28 | $302.00 | $2,818.38 |
United Setting Professional Modifier None Typical Low $67.61 Median $91.20 Typical High $177.83 | Professional | None | $67.61 | $91.20 | $177.83 |
Wellpoint Setting Professional Modifier None Typical Low $79.43 Median $95.50 Typical High $95.50 | Professional | None | $79.43 | $95.50 | $95.50 |
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 $38.90 Median $44.67 Typical High $58.88 | Professional | 52 · Reduced service | $38.90 | $44.67 | $58.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.49 Median $17.78 Typical High $23.99 | Professional | 53 · Discontinued | $15.49 | $17.78 | $23.99 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $58.88 Median $67.61 Typical High $89.13 | Professional | 54 · Surgery only | $58.88 | $67.61 | $89.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.75 Median $13.49 Typical High $17.78 | Professional | 55 · Aftercare only | $11.75 | $13.49 | $17.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.76 Median $8.91 Typical High $12.02 | Professional | 56 · Pre-op care only | $7.76 | $8.91 | $12.02 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $54.95 Median $63.10 Typical High $83.18 | Professional | 78 · Unplanned return to OR | $54.95 | $63.10 | $83.18 |
Where Florida sits
The same service costs 4.5 times more in Alaska than in Florida. 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· 51st of 51
$95.50
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.