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 $89.13 Median $125.89 Typical High $162.18 | Professional | None | $89.13 | $125.89 | $162.18 |
AvMed Setting Facility Modifier None Typical Low $125.89 Median $2,137.96 Typical High $11,748.98 | Facility | None | $125.89 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $100.00 Median $147.91 Typical High $194.98 | Professional | None | $100.00 | $147.91 | $194.98 |
Cigna Setting Facility Modifier None Typical Low $52.48 Median $138.04 Typical High $269.15 | Facility | None | $52.48 | $138.04 | $269.15 |
Cigna Setting Professional Modifier None Typical Low $77.62 Median $123.03 Typical High $194.98 | Professional | None | $77.62 | $123.03 | $194.98 |
Florida Blue Setting Facility Modifier None Typical Low $114.82 Median $251.19 Typical High $3,981.07 | Facility | None | $114.82 | $251.19 | $3,981.07 |
Florida Blue Setting Professional Modifier None Typical Low $72.44 Median $128.82 Typical High $208.93 | Professional | None | $72.44 | $128.82 | $208.93 |
Molina Setting Professional Modifier None Typical Low $100.00 Median $154.88 Typical High $338.84 | Professional | None | $100.00 | $154.88 | $338.84 |
United Setting Facility Modifier None Typical Low $81.28 Median $302.00 Typical High $2,818.38 | Facility | None | $81.28 | $302.00 | $2,818.38 |
United Setting Professional Modifier None Typical Low $79.43 Median $123.03 Typical High $204.17 | Professional | None | $79.43 | $123.03 | $204.17 |
Wellpoint Setting Professional Modifier None Typical Low $75.86 Median $144.54 Typical High $144.54 | Professional | None | $75.86 | $144.54 | $144.54 |
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 $44.67 Median $63.10 Typical High $81.28 | Professional | 52 · Reduced service | $44.67 | $63.10 | $81.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.20 Median $25.12 Typical High $32.36 | Professional | 53 · Discontinued | $18.20 | $25.12 | $32.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $67.61 Median $95.50 Typical High $123.03 | Professional | 54 · Surgery only | $67.61 | $95.50 | $123.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.49 Median $19.05 Typical High $24.55 | Professional | 55 · Aftercare only | $13.49 | $19.05 | $24.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.91 Median $12.59 Typical High $16.22 | Professional | 56 · Pre-op care only | $8.91 | $12.59 | $16.22 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $63.10 Median $89.13 Typical High $114.82 | Professional | 78 · Unplanned return to OR | $63.10 | $89.13 | $114.82 |
Where Florida sits
The same service costs 3.5 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· 50th of 51
$129
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.