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 $12,022.64 | Facility | None | $776.25 | $6,025.60 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $331.13 Median $354.81 Typical High $446.68 | Professional | None | $331.13 | $354.81 | $446.68 |
AvMed Setting Facility Modifier None Typical Low $501.19 Median $2,137.96 Typical High $9,772.37 | Facility | None | $501.19 | $2,137.96 | $9,772.37 |
AvMed Setting Professional Modifier None Typical Low $338.84 Median $398.11 Typical High $489.78 | Professional | None | $338.84 | $398.11 | $489.78 |
Cigna Setting Facility Modifier None Typical Low $616.60 Median $2,041.74 Typical High $3,311.31 | Facility | None | $616.60 | $2,041.74 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $302.00 Median $323.59 Typical High $575.44 | Professional | None | $302.00 | $323.59 | $575.44 |
Florida Blue Setting Facility Modifier None Typical Low $1,230.27 Median $2,630.27 Typical High $16,982.44 | Facility | None | $1,230.27 | $2,630.27 | $16,982.44 |
Florida Blue Setting Professional Modifier None Typical Low $190.55 Median $398.11 Typical High $489.78 | Professional | None | $190.55 | $398.11 | $489.78 |
Molina Setting Professional Modifier None Typical Low $75.86 Median $331.13 Typical High $724.44 | Professional | None | $75.86 | $331.13 | $724.44 |
United Setting Facility Modifier None Typical Low $954.99 Median $2,344.23 Typical High $10,000.00 | Facility | None | $954.99 | $2,344.23 | $10,000.00 |
United Setting Professional Modifier None Typical Low $281.84 Median $363.08 Typical High $602.56 | Professional | None | $281.84 | $363.08 | $602.56 |
Wellpoint Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $309.03 | Professional | None | $309.03 | $309.03 | $309.03 |
7 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 $162.18 Median $177.83 Typical High $223.87 | Professional | 52 · Reduced service | $162.18 | $177.83 | $223.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $70.79 Typical High $89.13 | Professional | 53 · Discontinued | $66.07 | $70.79 | $89.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $269.15 Typical High $331.13 | Professional | 54 · Surgery only | $245.47 | $269.15 | $331.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $53.70 Typical High $66.07 | Professional | 55 · Aftercare only | $48.98 | $53.70 | $66.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $35.48 Typical High $44.67 | Professional | 56 · Pre-op care only | $33.11 | $35.48 | $44.67 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $229.09 Median $251.19 Typical High $309.03 | Professional | 78 · Unplanned return to OR | $229.09 | $251.19 | $309.03 |
Ambetter Setting Professional Modifier 50 · Both sides Typical Low $1,230.27 Median $1,230.27 Typical High $1,230.27 | Professional | 50 · Both sides | $1,230.27 | $1,230.27 | $1,230.27 |
Where Florida sits
The same service costs 5.6 times more in Alaska than in Utah. 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.