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 $281.84 Median $4,786.30 Typical High $12,022.64 | Facility | None | $281.84 | $4,786.30 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $213.80 Median $281.84 Typical High $398.11 | Professional | None | $213.80 | $281.84 | $398.11 |
AvMed Setting Facility Modifier None Typical Low $380.19 Median $2,137.96 Typical High $11,748.98 | Facility | None | $380.19 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $302.00 Median $398.11 Typical High $537.03 | Professional | None | $302.00 | $398.11 | $537.03 |
Cigna Setting Facility Modifier None Typical Low $389.05 Median $537.03 Typical High $2,691.53 | Facility | None | $389.05 | $537.03 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $213.80 Median $331.13 Typical High $489.78 | Professional | None | $213.80 | $331.13 | $489.78 |
Florida Blue Setting Facility Modifier None Typical Low $275.42 Median $588.84 Typical High $16,982.44 | Facility | None | $275.42 | $588.84 | $16,982.44 |
Florida Blue Setting Professional Modifier None Typical Low $162.18 Median $251.19 Typical High $575.44 | Professional | None | $162.18 | $251.19 | $575.44 |
Molina Setting Professional Modifier None Typical Low $27.54 Median $380.19 Typical High $933.25 | Professional | None | $27.54 | $380.19 | $933.25 |
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 $204.17 Median $302.00 Typical High $512.86 | Professional | None | $204.17 | $302.00 | $512.86 |
Wellpoint Setting Professional Modifier None Typical Low $234.42 Median $398.11 Typical High $398.11 | Professional | None | $234.42 | $398.11 | $398.11 |
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 $107.15 Median $141.25 Typical High $190.55 | Professional | 52 · Reduced service | $107.15 | $141.25 | $190.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $42.66 Median $56.23 Typical High $75.86 | Professional | 53 · Discontinued | $42.66 | $56.23 | $75.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $158.49 Median $213.80 Typical High $281.84 | Professional | 54 · Surgery only | $158.49 | $213.80 | $281.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $42.66 Typical High $56.23 | Professional | 55 · Aftercare only | $31.62 | $42.66 | $56.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.38 Median $28.18 Typical High $38.02 | Professional | 56 · Pre-op care only | $21.38 | $28.18 | $38.02 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $147.91 Median $199.53 Typical High $263.03 | Professional | 78 · Unplanned return to OR | $147.91 | $199.53 | $263.03 |
Where Florida sits
The same service costs 4.3 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· 47th of 51
$339
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.