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 $630.96 Median $4,786.30 Typical High $11,748.98 | Facility | None | $630.96 | $4,786.30 | $11,748.98 |
Aetna Setting Professional Modifier None Typical Low $549.54 Median $588.84 Typical High $758.58 | Professional | None | $549.54 | $588.84 | $758.58 |
AvMed Setting Facility Modifier None Typical Low $512.86 Median $2,137.96 Typical High $9,772.37 | Facility | None | $512.86 | $2,137.96 | $9,772.37 |
AvMed Setting Professional Modifier None Typical Low $489.78 Median $645.65 Typical High $724.44 | Professional | None | $489.78 | $645.65 | $724.44 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $2,691.53 Typical High $4,786.30 | Facility | None | $501.19 | $2,691.53 | $4,786.30 |
Cigna Setting Professional Modifier None Typical Low $446.68 Median $630.96 Typical High $1,202.26 | Professional | None | $446.68 | $630.96 | $1,202.26 |
Florida Blue Setting Facility Modifier None Typical Low $891.25 Median $1,737.80 Typical High $16,982.44 | Facility | None | $891.25 | $1,737.80 | $16,982.44 |
Florida Blue Setting Professional Modifier None Typical Low $416.87 Median $446.68 Typical High $676.08 | Professional | None | $416.87 | $446.68 | $676.08 |
Molina Setting Professional Modifier None Typical Low $75.86 Median $562.34 Typical High $1,096.48 | Professional | None | $75.86 | $562.34 | $1,096.48 |
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 $60.26 Median $691.83 Typical High $1,318.26 | Professional | None | $60.26 | $691.83 | $1,318.26 |
Wellpoint Setting Professional Modifier None Typical Low $446.68 Median $446.68 Typical High $588.84 | Professional | None | $446.68 | $446.68 | $588.84 |
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 $295.12 Typical High $371.54 | Professional | 52 · Reduced service | $275.42 | $295.12 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $117.49 Typical High $147.91 | Professional | 53 · Discontinued | $109.65 | $117.49 | $147.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $416.87 Median $436.52 Typical High $549.54 | Professional | 54 · Surgery only | $416.87 | $436.52 | $549.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $89.13 Typical High $109.65 | Professional | 55 · Aftercare only | $83.18 | $89.13 | $109.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $58.88 Typical High $74.13 | Professional | 56 · Pre-op care only | $54.95 | $58.88 | $74.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $389.05 Median $407.38 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $389.05 | $407.38 | $512.86 |
Where Florida sits
The same service costs 5.4 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· 44th of 51
$741
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.