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 $707.95 Median $776.25 Typical High $977.24 | Professional | None | $707.95 | $776.25 | $977.24 |
AvMed Setting Facility Modifier None Typical Low $630.96 Median $2,137.96 Typical High $11,748.98 | Facility | None | $630.96 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $630.96 Median $851.14 Typical High $933.25 | Professional | None | $630.96 | $851.14 | $933.25 |
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 $588.84 Median $831.76 Typical High $1,584.89 | Professional | None | $588.84 | $831.76 | $1,584.89 |
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 $537.03 Median $575.44 Typical High $891.25 | Professional | None | $537.03 | $575.44 | $891.25 |
Molina Setting Professional Modifier None Typical Low $54.95 Median $676.08 Typical High $1,380.38 | Professional | None | $54.95 | $676.08 | $1,380.38 |
United Setting Facility Modifier None Typical Low $954.99 Median $2,290.87 Typical High $10,232.93 | Facility | None | $954.99 | $2,290.87 | $10,232.93 |
United Setting Professional Modifier None Typical Low $60.26 Median $912.01 Typical High $1,737.80 | Professional | None | $60.26 | $912.01 | $1,737.80 |
Wellpoint Setting Professional Modifier None Typical Low $575.44 Median $575.44 Typical High $758.58 | Professional | None | $575.44 | $575.44 | $758.58 |
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 $354.81 Median $389.05 Typical High $478.63 | Professional | 52 · Reduced service | $354.81 | $389.05 | $478.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $141.25 Median $154.88 Typical High $190.55 | Professional | 53 · Discontinued | $141.25 | $154.88 | $190.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $588.84 Typical High $724.44 | Professional | 54 · Surgery only | $537.03 | $588.84 | $724.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $117.49 Typical High $144.54 | Professional | 55 · Aftercare only | $107.15 | $117.49 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $77.62 Typical High $95.50 | Professional | 56 · Pre-op care only | $70.79 | $77.62 | $95.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $549.54 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $501.19 | $549.54 | $676.08 |
Ambetter Setting Professional Modifier 51 · Multiple procedures Typical Low $436.52 Median $436.52 Typical High $436.52 | Professional | 51 · Multiple procedures | $436.52 | $436.52 | $436.52 |
Where Florida sits
The same service costs 6.2 times more in Oklahoma 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· 49th of 51
$776
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.