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 $229.09 Median $3,801.89 Typical High $12,882.50 | Facility | None | $229.09 | $3,801.89 | $12,882.50 |
Aetna Setting Professional Modifier None Typical Low $204.17 Median $218.78 Typical High $588.84 | Professional | None | $204.17 | $218.78 | $588.84 |
AvMed Setting Facility Modifier None Typical Low $234.42 Median $2,137.96 Typical High $12,882.50 | Facility | None | $234.42 | $2,137.96 | $12,882.50 |
AvMed Setting Professional Modifier None Typical Low $213.80 Median $257.04 Typical High $562.34 | Professional | None | $213.80 | $257.04 | $562.34 |
Cigna Setting Facility Modifier None Typical Low $177.83 Median $338.84 Typical High $11,481.54 | Facility | None | $177.83 | $338.84 | $11,481.54 |
Cigna Setting Professional Modifier None Typical Low $190.55 Median $213.80 Typical High $588.84 | Professional | None | $190.55 | $213.80 | $588.84 |
Florida Blue Setting Facility Modifier None Typical Low $199.53 Median $436.52 Typical High $3,981.07 | Facility | None | $199.53 | $436.52 | $3,981.07 |
Florida Blue Setting Professional Modifier None Typical Low $204.17 Median $316.23 Typical High $630.96 | Professional | None | $204.17 | $316.23 | $630.96 |
Molina Setting Professional Modifier None Typical Low $27.54 Median $208.93 Typical High $363.08 | Professional | None | $27.54 | $208.93 | $363.08 |
United Setting Facility Modifier None Typical Low $281.84 Median $660.69 Typical High $4,073.80 | Facility | None | $281.84 | $660.69 | $4,073.80 |
United Setting Professional Modifier None Typical Low $194.98 Median $269.15 Typical High $676.08 | Professional | None | $194.98 | $269.15 | $676.08 |
Wellpoint Setting Professional Modifier None Typical Low $186.21 Median $275.42 Typical High $275.42 | Professional | None | $186.21 | $275.42 | $275.42 |
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 $102.33 Median $109.65 Typical High $162.18 | Professional | 52 · Reduced service | $102.33 | $109.65 | $162.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $43.65 Typical High $66.07 | Professional | 53 · Discontinued | $40.74 | $43.65 | $66.07 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $151.36 Median $165.96 Typical High $245.47 | Professional | 54 · Surgery only | $151.36 | $165.96 | $245.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $33.11 Typical High $48.98 | Professional | 55 · Aftercare only | $30.20 | $33.11 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $21.88 Typical High $33.11 | Professional | 56 · Pre-op care only | $20.42 | $21.88 | $33.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $141.25 Median $154.88 Typical High $229.09 | Professional | 78 · Unplanned return to OR | $141.25 | $154.88 | $229.09 |
Where Florida sits
The same service costs 5.0 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· 50th of 51
$263
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.