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 $4,786.30 Typical High $11,748.98 | Facility | None | $776.25 | $4,786.30 | $11,748.98 |
Aetna Setting Professional Modifier None Typical Low $812.83 Median $851.14 Typical High $1,202.26 | Professional | None | $812.83 | $851.14 | $1,202.26 |
AvMed Setting Facility Modifier None Typical Low $741.31 Median $2,089.30 Typical High $9,772.37 | Facility | None | $741.31 | $2,089.30 | $9,772.37 |
AvMed Setting Professional Modifier None Typical Low $707.95 Median $933.25 Typical High $1,000.00 | Professional | None | $707.95 | $933.25 | $1,000.00 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $1,479.11 Typical High $2,691.53 | Facility | None | $501.19 | $1,479.11 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $758.58 Median $776.25 Typical High $1,584.89 | Professional | None | $758.58 | $776.25 | $1,584.89 |
Florida Blue Setting Facility Modifier None Typical Low $912.01 Median $1,995.26 Typical High $7,413.10 | Facility | None | $912.01 | $1,995.26 | $7,413.10 |
Florida Blue Setting Professional Modifier None Typical Low $416.87 Median $691.83 Typical High $1,096.48 | Professional | None | $416.87 | $691.83 | $1,096.48 |
Molina Setting Professional Modifier None Typical Low $67.61 Median $602.56 Typical High $1,148.15 | Professional | None | $67.61 | $602.56 | $1,148.15 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $3,311.31 Typical High $12,589.25 | Facility | None | $1,230.27 | $3,311.31 | $12,589.25 |
United Setting Professional Modifier None Typical Low $630.96 Median $891.25 Typical High $1,584.89 | Professional | None | $630.96 | $891.25 | $1,584.89 |
Wellpoint Setting Professional Modifier None Typical Low $724.44 Median $1,000.00 Typical High $1,000.00 | Professional | None | $724.44 | $1,000.00 | $1,000.00 |
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 $407.38 Median $426.58 Typical High $588.84 | Professional | 52 · Reduced service | $407.38 | $426.58 | $588.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $169.82 Typical High $234.42 | Professional | 53 · Discontinued | $162.18 | $169.82 | $234.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $602.56 Median $630.96 Typical High $891.25 | Professional | 54 · Surgery only | $602.56 | $630.96 | $891.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $128.82 Typical High $177.83 | Professional | 55 · Aftercare only | $123.03 | $128.82 | $177.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $85.11 Typical High $117.49 | Professional | 56 · Pre-op care only | $81.28 | $85.11 | $117.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $562.34 Median $588.84 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $562.34 | $588.84 | $831.76 |
Where Florida sits
The same service costs 7.6 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· 47th of 51
$955
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.