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 $707.95 Median $5,495.41 Typical High $12,022.64 | Facility | None | $707.95 | $5,495.41 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $549.54 Median $660.69 Typical High $831.76 | Professional | None | $549.54 | $660.69 | $831.76 |
AvMed Setting Facility Modifier None Typical Low $630.96 Median $2,137.96 Typical High $9,549.93 | Facility | None | $630.96 | $2,137.96 | $9,549.93 |
AvMed Setting Professional Modifier None Typical Low $602.56 Median $724.44 Typical High $933.25 | Professional | None | $602.56 | $724.44 | $933.25 |
Cigna Setting Facility Modifier None Typical Low $616.60 Median $3,235.94 Typical High $5,370.32 | Facility | None | $616.60 | $3,235.94 | $5,370.32 |
Cigna Setting Professional Modifier None Typical Low $478.63 Median $630.96 Typical High $1,000.00 | Professional | None | $478.63 | $630.96 | $1,000.00 |
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 $371.54 Median $676.08 Typical High $1,000.00 | Professional | None | $371.54 | $676.08 | $1,000.00 |
Molina Setting Professional Modifier None Typical Low $54.95 Median $645.65 Typical High $1,548.82 | Professional | None | $54.95 | $645.65 | $1,548.82 |
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 $489.78 Median $660.69 Typical High $1,096.48 | Professional | None | $489.78 | $660.69 | $1,096.48 |
Wellpoint Setting Professional Modifier None Typical Low $467.74 Median $660.69 Typical High $660.69 | Professional | None | $467.74 | $660.69 | $660.69 |
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 $275.42 Median $331.13 Typical High $407.38 | Professional | 52 · Reduced service | $275.42 | $331.13 | $407.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $131.83 Typical High $162.18 | Professional | 53 · Discontinued | $109.65 | $131.83 | $162.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $407.38 Median $489.78 Typical High $616.60 | Professional | 54 · Surgery only | $407.38 | $489.78 | $616.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $97.72 Typical High $123.03 | Professional | 55 · Aftercare only | $81.28 | $97.72 | $123.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $66.07 Typical High $81.28 | Professional | 56 · Pre-op care only | $54.95 | $66.07 | $81.28 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $380.19 Median $457.09 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $380.19 | $457.09 | $575.44 |
Where Florida sits
The same service costs 4.4 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
$661
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.