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 $478.63 Median $3,801.89 Typical High $10,964.78 | Facility | None | $478.63 | $3,801.89 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $239.88 Median $354.81 Typical High $467.74 | Professional | None | $239.88 | $354.81 | $467.74 |
AvMed Setting Facility Modifier None Typical Low $416.87 Median $1,698.24 Typical High $9,549.93 | Facility | None | $416.87 | $1,698.24 | $9,549.93 |
AvMed Setting Professional Modifier None Typical Low $275.42 Median $331.13 Typical High $501.19 | Professional | None | $275.42 | $331.13 | $501.19 |
Cigna Setting Facility Modifier None Typical Low $436.52 Median $1,949.84 Typical High $3,019.95 | Facility | None | $436.52 | $1,949.84 | $3,019.95 |
Cigna Setting Professional Modifier None Typical Low $204.17 Median $323.59 Typical High $707.95 | Professional | None | $204.17 | $323.59 | $707.95 |
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 $275.42 Median $288.40 Typical High $489.78 | Professional | None | $275.42 | $288.40 | $489.78 |
Molina Setting Professional Modifier None Typical Low $34.67 Median $346.74 Typical High $707.95 | Professional | None | $34.67 | $346.74 | $707.95 |
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 $218.78 Median $398.11 Typical High $758.58 | Professional | None | $218.78 | $398.11 | $758.58 |
Wellpoint Setting Professional Modifier None Typical Low $199.53 Median $288.40 Typical High $288.40 | Professional | None | $199.53 | $288.40 | $288.40 |
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 $120.23 Median $177.83 Typical High $208.93 | Professional | 52 · Reduced service | $120.23 | $177.83 | $208.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $47.86 Median $70.79 Typical High $83.18 | Professional | 53 · Discontinued | $47.86 | $70.79 | $83.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $177.83 Median $269.15 Typical High $316.23 | Professional | 54 · Surgery only | $177.83 | $269.15 | $316.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $53.70 Typical High $63.10 | Professional | 55 · Aftercare only | $35.48 | $53.70 | $63.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $35.48 Typical High $41.69 | Professional | 56 · Pre-op care only | $23.99 | $35.48 | $41.69 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $165.96 Median $251.19 Typical High $295.12 | Professional | 78 · Unplanned return to OR | $165.96 | $251.19 | $295.12 |
Where Florida sits
The same service costs 4.8 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
$427
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.