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 $1,023.29 Median $5,128.61 Typical High $14,791.08 | Facility | None | $1,023.29 | $5,128.61 | $14,791.08 |
Aetna Setting Professional Modifier None Typical Low $933.25 Median $1,096.48 Typical High $1,288.25 | Professional | None | $933.25 | $1,096.48 | $1,288.25 |
AvMed Setting Facility Modifier None Typical Low $812.83 Median $2,137.96 Typical High $11,748.98 | Facility | None | $812.83 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $831.76 Median $1,096.48 Typical High $1,230.27 | Professional | None | $831.76 | $1,096.48 | $1,230.27 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $501.19 Typical High $2,691.53 | Facility | None | $398.11 | $501.19 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $776.25 Median $1,096.48 Typical High $2,089.30 | Professional | None | $776.25 | $1,096.48 | $2,089.30 |
Florida Blue Setting Facility Modifier None Typical Low $10,471.29 Median $22,387.21 Typical High $33,884.42 | Facility | None | $10,471.29 | $22,387.21 | $33,884.42 |
Florida Blue Setting Professional Modifier None Typical Low $707.95 Median $758.58 Typical High $1,148.15 | Professional | None | $707.95 | $758.58 | $1,148.15 |
Molina Setting Professional Modifier None Typical Low $104.71 Median $891.25 Typical High $1,778.28 | Professional | None | $104.71 | $891.25 | $1,778.28 |
United Setting Facility Modifier None Typical Low $371.54 Median $954.99 Typical High $7,585.78 | Facility | None | $371.54 | $954.99 | $7,585.78 |
United Setting Professional Modifier None Typical Low $60.26 Median $1,202.26 Typical High $2,344.23 | Professional | None | $60.26 | $1,202.26 | $2,344.23 |
Wellpoint Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $1,000.00 | Professional | None | $758.58 | $758.58 | $1,000.00 |
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 $467.74 Median $537.03 Typical High $630.96 | Professional | 52 · Reduced service | $467.74 | $537.03 | $630.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $186.21 Median $213.80 Typical High $251.19 | Professional | 53 · Discontinued | $186.21 | $213.80 | $251.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $812.83 Typical High $954.99 | Professional | 54 · Surgery only | $691.83 | $812.83 | $954.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $162.18 Typical High $190.55 | Professional | 55 · Aftercare only | $138.04 | $162.18 | $190.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $107.15 Typical High $125.89 | Professional | 56 · Pre-op care only | $93.33 | $107.15 | $125.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $758.58 Typical High $891.25 | Professional | 78 · Unplanned return to OR | $645.65 | $758.58 | $891.25 |
Where Florida sits
The same service costs 5.9 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
$977
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.