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 $426.58 Median $3,311.31 Typical High $10,964.78 | Facility | None | $426.58 | $3,311.31 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $275.42 Median $354.81 Typical High $446.68 | Professional | None | $275.42 | $354.81 | $446.68 |
AvMed Setting Facility Modifier None Typical Low $446.68 Median $1,819.70 Typical High $9,549.93 | Facility | None | $446.68 | $1,819.70 | $9,549.93 |
AvMed Setting Professional Modifier None Typical Low $309.03 Median $389.05 Typical High $501.19 | Professional | None | $309.03 | $389.05 | $501.19 |
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 $234.42 Median $316.23 Typical High $549.54 | Professional | None | $234.42 | $316.23 | $549.54 |
Florida Blue Setting Facility Modifier None Typical Low $1,071.52 Median $2,089.30 Typical High $16,982.44 | Facility | None | $1,071.52 | $2,089.30 | $16,982.44 |
Florida Blue Setting Professional Modifier None Typical Low $199.53 Median $354.81 Typical High $537.03 | Professional | None | $199.53 | $354.81 | $537.03 |
Molina Setting Professional Modifier None Typical Low $27.54 Median $363.08 Typical High $851.14 | Professional | None | $27.54 | $363.08 | $851.14 |
United Setting Facility Modifier None Typical Low $794.33 Median $1,778.28 Typical High $7,585.78 | Facility | None | $794.33 | $1,778.28 | $7,585.78 |
United Setting Professional Modifier None Typical Low $251.19 Median $346.74 Typical High $575.44 | Professional | None | $251.19 | $346.74 | $575.44 |
Wellpoint Setting Professional Modifier None Typical Low $234.42 Median $363.08 Typical High $363.08 | Professional | None | $234.42 | $363.08 | $363.08 |
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 $138.04 Median $177.83 Typical High $213.80 | Professional | 52 · Reduced service | $138.04 | $177.83 | $213.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $70.79 Typical High $85.11 | Professional | 53 · Discontinued | $54.95 | $70.79 | $85.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $263.03 Typical High $323.59 | Professional | 54 · Surgery only | $208.93 | $263.03 | $323.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $52.48 Typical High $64.57 | Professional | 55 · Aftercare only | $41.69 | $52.48 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $35.48 Typical High $42.66 | Professional | 56 · Pre-op care only | $27.54 | $35.48 | $42.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $194.98 Median $245.47 Typical High $302.00 | Professional | 78 · Unplanned return to OR | $194.98 | $245.47 | $302.00 |
Where Florida sits
The same service costs 4.0 times more in Alaska than in New Jersey. 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
$355
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.