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 $660.69 Median $5,495.41 Typical High $12,022.64 | Facility | None | $660.69 | $5,495.41 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $389.05 Median $407.38 Typical High $707.95 | Professional | None | $389.05 | $407.38 | $707.95 |
Ambetter Setting Professional Modifier None Typical Low $407.38 Median $407.38 Typical High $549.54 | Professional | None | $407.38 | $407.38 | $549.54 |
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 $354.81 Median $467.74 Typical High $512.86 | Professional | None | $354.81 | $467.74 | $512.86 |
Cigna Setting Facility Modifier None Typical Low $616.60 Median $1,995.26 Typical High $3,311.31 | Facility | None | $616.60 | $1,995.26 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $323.59 Median $457.09 Typical High $870.96 | Professional | None | $323.59 | $457.09 | $870.96 |
Florida Blue Setting Facility Modifier None Typical Low $977.24 Median $1,949.84 Typical High $16,982.44 | Facility | None | $977.24 | $1,949.84 | $16,982.44 |
Florida Blue Setting Professional Modifier None Typical Low $302.00 Median $323.59 Typical High $478.63 | Professional | None | $302.00 | $323.59 | $478.63 |
Molina Setting Professional Modifier None Typical Low $42.66 Median $389.05 Typical High $776.25 | Professional | None | $42.66 | $389.05 | $776.25 |
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 $501.19 Typical High $954.99 | Professional | None | $60.26 | $501.19 | $954.99 |
Wellpoint Setting Professional Modifier None Typical Low $323.59 Median $323.59 Typical High $426.58 | Professional | None | $323.59 | $323.59 | $426.58 |
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 $194.98 Median $199.53 Typical High $269.15 | Professional | 52 · Reduced service | $194.98 | $199.53 | $269.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $79.43 Typical High $107.15 | Professional | 53 · Discontinued | $79.43 | $79.43 | $107.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $295.12 Median $302.00 Typical High $398.11 | Professional | 54 · Surgery only | $295.12 | $302.00 | $398.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $60.26 Typical High $81.28 | Professional | 55 · Aftercare only | $58.88 | $60.26 | $81.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $39.81 Typical High $53.70 | Professional | 56 · Pre-op care only | $38.90 | $39.81 | $53.70 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $275.42 Median $281.84 Typical High $371.54 | Professional | 78 · Unplanned return to OR | $275.42 | $281.84 | $371.54 |
Where Florida sits
The same service costs 8.7 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· 31st of 51
$646
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.