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 $549.54 Median $3,715.35 Typical High $11,481.54 | Facility | None | $549.54 | $3,715.35 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $346.74 Median $363.08 Typical High $457.09 | Professional | None | $346.74 | $363.08 | $457.09 |
AvMed Setting Facility Modifier None Typical Low $389.05 Median $2,137.96 Typical High $11,748.98 | Facility | None | $389.05 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $346.74 Median $426.58 Typical High $489.78 | Professional | None | $346.74 | $426.58 | $489.78 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $501.19 Typical High $2,187.76 | Facility | None | $398.11 | $501.19 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $316.23 Median $436.52 Typical High $812.83 | Professional | None | $316.23 | $436.52 | $812.83 |
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 $288.40 Median $309.03 Typical High $426.58 | Professional | None | $288.40 | $309.03 | $426.58 |
Molina Setting Professional Modifier None Typical Low $67.61 Median $275.42 Typical High $575.44 | Professional | None | $67.61 | $275.42 | $575.44 |
United Setting Facility Modifier None Typical Low $371.54 Median $954.99 Typical High $7,585.78 | Facility | None | $371.54 | $954.99 | $7,585.78 |
United Setting Professional Modifier None Typical Low $60.26 Median $457.09 Typical High $891.25 | Professional | None | $60.26 | $457.09 | $891.25 |
Wellpoint Setting Professional Modifier None Typical Low $302.00 Median $302.00 Typical High $407.38 | Professional | None | $302.00 | $302.00 | $407.38 |
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 $173.78 Median $181.97 Typical High $213.80 | Professional | 52 · Reduced service | $173.78 | $181.97 | $213.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $72.44 Typical High $85.11 | Professional | 53 · Discontinued | $69.18 | $72.44 | $85.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $257.04 Median $275.42 Typical High $323.59 | Professional | 54 · Surgery only | $257.04 | $275.42 | $323.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $51.29 Median $54.95 Typical High $64.57 | Professional | 55 · Aftercare only | $51.29 | $54.95 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $36.31 Typical High $42.66 | Professional | 56 · Pre-op care only | $34.67 | $36.31 | $42.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $239.88 Median $257.04 Typical High $302.00 | Professional | 78 · Unplanned return to OR | $239.88 | $257.04 | $302.00 |
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· 48th of 51
$398
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.