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 $141.25 Median $218.78 Typical High $302.00 | Professional | None | $141.25 | $218.78 | $302.00 |
AvMed Setting Facility Modifier None Typical Low $281.84 Median $2,137.96 Typical High $11,748.98 | Facility | None | $281.84 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $190.55 Median $302.00 Typical High $398.11 | Professional | None | $190.55 | $302.00 | $398.11 |
Cigna Setting Facility Modifier None Typical Low $288.40 Median $457.09 Typical High $2,691.53 | Facility | None | $288.40 | $457.09 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $144.54 Median $245.47 Typical High $371.54 | Professional | None | $144.54 | $245.47 | $371.54 |
Florida Blue Setting Facility Modifier None Typical Low $199.53 Median $436.52 Typical High $6,309.57 | Facility | None | $199.53 | $436.52 | $6,309.57 |
Florida Blue Setting Professional Modifier None Typical Low $123.03 Median $223.87 Typical High $436.52 | Professional | None | $123.03 | $223.87 | $436.52 |
Molina Setting Professional Modifier None Typical Low $27.54 Median $269.15 Typical High $660.69 | Professional | None | $27.54 | $269.15 | $660.69 |
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 $141.25 Median $223.87 Typical High $389.05 | Professional | None | $141.25 | $223.87 | $389.05 |
Wellpoint Setting Professional Modifier None Typical Low $147.91 Median $234.42 Typical High $234.42 | Professional | None | $147.91 | $234.42 | $234.42 |
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 $70.79 Median $107.15 Typical High $144.54 | Professional | 52 · Reduced service | $70.79 | $107.15 | $144.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $43.65 Typical High $58.88 | Professional | 53 · Discontinued | $28.18 | $43.65 | $58.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $104.71 Median $162.18 Typical High $218.78 | Professional | 54 · Surgery only | $104.71 | $162.18 | $218.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $32.36 Typical High $43.65 | Professional | 55 · Aftercare only | $20.89 | $32.36 | $43.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $21.88 Typical High $28.84 | Professional | 56 · Pre-op care only | $14.13 | $21.88 | $28.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $97.72 Median $151.36 Typical High $204.17 | Professional | 78 · Unplanned return to OR | $97.72 | $151.36 | $204.17 |
Where Florida sits
The same service costs 3.5 times more in Alaska than in Kentucky. 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· 48th of 51
$245
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.