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 $446.68 Median $457.09 Typical High $616.60 | Professional | None | $446.68 | $457.09 | $616.60 |
AvMed Setting Facility Modifier None Typical Low $457.09 Median $2,137.96 Typical High $11,748.98 | Facility | None | $457.09 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $426.58 Median $537.03 Typical High $602.56 | Professional | None | $426.58 | $537.03 | $602.56 |
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 $398.11 Median $537.03 Typical High $1,023.29 | Professional | None | $398.11 | $537.03 | $1,023.29 |
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 $363.08 Median $389.05 Typical High $549.54 | Professional | None | $363.08 | $389.05 | $549.54 |
Molina Setting Professional Modifier None Typical Low $69.18 Median $436.52 Typical High $870.96 | Professional | None | $69.18 | $436.52 | $870.96 |
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 $602.56 Typical High $1,122.02 | Professional | None | $60.26 | $602.56 | $1,122.02 |
Wellpoint Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $512.86 | Professional | None | $389.05 | $389.05 | $512.86 |
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 $223.87 Median $229.09 Typical High $295.12 | Professional | 52 · Reduced service | $223.87 | $229.09 | $295.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $91.20 Typical High $117.49 | Professional | 53 · Discontinued | $89.13 | $91.20 | $117.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $338.84 Median $346.74 Typical High $436.52 | Professional | 54 · Surgery only | $338.84 | $346.74 | $436.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $69.18 Typical High $89.13 | Professional | 55 · Aftercare only | $67.61 | $69.18 | $89.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $45.71 Typical High $58.88 | Professional | 56 · Pre-op care only | $44.67 | $45.71 | $58.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $316.23 Median $323.59 Typical High $407.38 | Professional | 78 · Unplanned return to OR | $316.23 | $323.59 | $407.38 |
Where Florida sits
The same service costs 6.0 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· 49th of 51
$513
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.