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 $549.54 Median $4,073.80 Typical High $11,481.54 | Facility | None | $549.54 | $4,073.80 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $478.63 Median $524.81 Typical High $741.31 | Professional | None | $478.63 | $524.81 | $741.31 |
AvMed Setting Facility Modifier None Typical Low $501.19 Median $1,995.26 Typical High $9,549.93 | Facility | None | $501.19 | $1,995.26 | $9,549.93 |
AvMed Setting Professional Modifier None Typical Low $501.19 Median $616.60 Typical High $691.83 | Professional | None | $501.19 | $616.60 | $691.83 |
Cigna Setting Facility Modifier None Typical Low $436.52 Median $2,818.38 Typical High $5,370.32 | Facility | None | $436.52 | $2,818.38 | $5,370.32 |
Cigna Setting Professional Modifier None Typical Low $467.74 Median $630.96 Typical High $1,174.90 | Professional | None | $467.74 | $630.96 | $1,174.90 |
Florida Blue Setting Facility Modifier None Typical Low $1,737.80 Median $3,548.13 Typical High $16,982.44 | Facility | None | $1,737.80 | $3,548.13 | $16,982.44 |
Florida Blue Setting Professional Modifier None Typical Low $416.87 Median $446.68 Typical High $588.84 | Professional | None | $416.87 | $446.68 | $588.84 |
Molina Setting Professional Modifier None Typical Low $69.18 Median $501.19 Typical High $1,023.29 | Professional | None | $69.18 | $501.19 | $1,023.29 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $3,311.31 Typical High $12,589.25 | Facility | None | $1,230.27 | $3,311.31 | $12,589.25 |
United Setting Professional Modifier None Typical Low $60.26 Median $660.69 Typical High $1,288.25 | Professional | None | $60.26 | $660.69 | $1,288.25 |
Wellpoint Setting Professional Modifier None Typical Low $457.09 Median $457.09 Typical High $588.84 | Professional | None | $457.09 | $457.09 | $588.84 |
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 $398.11 Typical High $537.03 | Professional | 54 · Surgery only | $363.08 | $398.11 | $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 $371.54 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $338.84 | $371.54 | $501.19 |
Where Florida sits
The same service costs 8.1 times more in Oklahoma 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· 45th of 51
$692
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.