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 $776.25 Median $3,890.45 Typical High $12,022.64 | Facility | None | $776.25 | $3,890.45 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $1,148.15 Median $1,288.25 Typical High $1,621.81 | Professional | None | $1,148.15 | $1,288.25 | $1,621.81 |
AvMed Setting Facility Modifier None Typical Low $1,071.52 Median $2,137.96 Typical High $11,748.98 | Facility | None | $1,071.52 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $1,122.02 Median $1,412.54 Typical High $1,621.81 | Professional | None | $1,122.02 | $1,412.54 | $1,621.81 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $501.19 Typical High $2,691.53 | Facility | None | $398.11 | $501.19 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $954.99 Median $1,445.44 Typical High $2,818.38 | Professional | None | $954.99 | $1,445.44 | $2,818.38 |
Florida Blue Setting Facility Modifier None Typical Low $10,471.29 Median $22,387.21 Typical High $33,884.42 | Facility | None | $10,471.29 | $22,387.21 | $33,884.42 |
Florida Blue Setting Professional Modifier None Typical Low $933.25 Median $1,000.00 Typical High $1,737.80 | Professional | None | $933.25 | $1,000.00 | $1,737.80 |
Molina Setting Professional Modifier None Typical Low $104.71 Median $1,202.26 Typical High $1,737.80 | Professional | None | $104.71 | $1,202.26 | $1,737.80 |
United Setting Facility Modifier None Typical Low $371.54 Median $954.99 Typical High $7,585.78 | Facility | None | $371.54 | $954.99 | $7,585.78 |
United Setting Professional Modifier None Typical Low $54.95 Median $1,513.56 Typical High $3,467.37 | Professional | None | $54.95 | $1,513.56 | $3,467.37 |
Wellpoint Setting Professional Modifier None Typical Low $977.24 Median $977.24 Typical High $1,412.54 | Professional | None | $977.24 | $977.24 | $1,412.54 |
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 $575.44 Median $645.65 Typical High $812.83 | Professional | 52 · Reduced service | $575.44 | $645.65 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $229.09 Median $257.04 Typical High $323.59 | Professional | 53 · Discontinued | $229.09 | $257.04 | $323.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $851.14 Median $954.99 Typical High $1,202.26 | Professional | 54 · Surgery only | $851.14 | $954.99 | $1,202.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $190.55 Typical High $239.88 | Professional | 55 · Aftercare only | $173.78 | $190.55 | $239.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $128.82 Typical High $162.18 | Professional | 56 · Pre-op care only | $114.82 | $128.82 | $162.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $794.33 Median $891.25 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $794.33 | $891.25 | $1,122.02 |
Where Florida sits
The same service costs 5.0 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
$1,318
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.