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 $6,025.60 Typical High $14,791.08 | Facility | None | $776.25 | $6,025.60 | $14,791.08 |
Aetna Setting Professional Modifier None Typical Low $562.34 Median $676.08 Typical High $758.58 | Professional | None | $562.34 | $676.08 | $758.58 |
AvMed Setting Facility Modifier None Typical Low $660.69 Median $2,951.21 Typical High $9,549.93 | Facility | None | $660.69 | $2,951.21 | $9,549.93 |
AvMed Setting Professional Modifier None Typical Low $524.81 Median $660.69 Typical High $776.25 | Professional | None | $524.81 | $660.69 | $776.25 |
Cigna Setting Facility Modifier None Typical Low $977.24 Median $3,467.37 Typical High $5,370.32 | Facility | None | $977.24 | $3,467.37 | $5,370.32 |
Cigna Setting Professional Modifier None Typical Low $501.19 Median $537.03 Typical High $977.24 | Professional | None | $501.19 | $537.03 | $977.24 |
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 $323.59 Median $676.08 Typical High $776.25 | Professional | None | $323.59 | $676.08 | $776.25 |
Molina Setting Professional Modifier None Typical Low $54.95 Median $501.19 Typical High $1,174.90 | Professional | None | $54.95 | $501.19 | $1,174.90 |
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 $489.78 Median $630.96 Typical High $1,047.13 | Professional | None | $489.78 | $630.96 | $1,047.13 |
Wellpoint Setting Professional Modifier None Typical Low $501.19 Median $501.19 Typical High $501.19 | Professional | None | $501.19 | $501.19 | $501.19 |
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 $281.84 Median $338.84 Typical High $380.19 | Professional | 52 · Reduced service | $281.84 | $338.84 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $134.90 Typical High $151.36 | Professional | 53 · Discontinued | $112.20 | $134.90 | $151.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $512.86 Typical High $575.44 | Professional | 54 · Surgery only | $426.58 | $512.86 | $575.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $102.33 Typical High $114.82 | Professional | 55 · Aftercare only | $85.11 | $102.33 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $67.61 Typical High $75.86 | Professional | 56 · Pre-op care only | $56.23 | $67.61 | $75.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $478.63 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $398.11 | $478.63 | $537.03 |
Where Florida sits
The same service costs 6.3 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· 49th of 51
$575
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.