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 $851.14 Median $6,025.60 Typical High $12,882.50 | Facility | None | $851.14 | $6,025.60 | $12,882.50 |
Aetna Setting Professional Modifier None Typical Low $1,000.00 Median $1,047.13 Typical High $1,479.11 | Professional | None | $1,000.00 | $1,047.13 | $1,479.11 |
AvMed Setting Facility Modifier None Typical Low $724.44 Median $2,187.76 Typical High $9,772.37 | Facility | None | $724.44 | $2,187.76 | $9,772.37 |
AvMed Setting Professional Modifier None Typical Low $891.25 Median $1,122.02 Typical High $1,258.93 | Professional | None | $891.25 | $1,122.02 | $1,258.93 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $2,511.89 Typical High $3,890.45 | Facility | None | $707.95 | $2,511.89 | $3,890.45 |
Cigna Setting Professional Modifier None Typical Low $933.25 Median $977.24 Typical High $1,862.09 | Professional | None | $933.25 | $977.24 | $1,862.09 |
Florida Blue Setting Facility Modifier None Typical Low $1,778.28 Median $3,548.13 Typical High $16,982.44 | Facility | None | $1,778.28 | $3,548.13 | $16,982.44 |
Florida Blue Setting Professional Modifier None Typical Low $501.19 Median $870.96 Typical High $1,348.96 | Professional | None | $501.19 | $870.96 | $1,348.96 |
Molina Setting Professional Modifier None Typical Low $102.33 Median $776.25 Typical High $1,445.44 | Professional | None | $102.33 | $776.25 | $1,445.44 |
United Setting Facility Modifier None Typical Low $954.99 Median $2,344.23 Typical High $10,000.00 | Facility | None | $954.99 | $2,344.23 | $10,000.00 |
United Setting Professional Modifier None Typical Low $741.31 Median $1,047.13 Typical High $1,905.46 | Professional | None | $741.31 | $1,047.13 | $1,905.46 |
Wellpoint Setting Professional Modifier None Typical Low $912.01 Median $1,230.27 Typical High $1,230.27 | Professional | None | $912.01 | $1,230.27 | $1,230.27 |
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 $489.78 Median $524.81 Typical High $724.44 | Professional | 52 · Reduced service | $489.78 | $524.81 | $724.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $208.93 Typical High $288.40 | Professional | 53 · Discontinued | $199.53 | $208.93 | $288.40 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $776.25 Typical High $1,071.52 | Professional | 54 · Surgery only | $741.31 | $776.25 | $1,071.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $154.88 Typical High $213.80 | Professional | 55 · Aftercare only | $147.91 | $154.88 | $213.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $104.71 Typical High $144.54 | Professional | 56 · Pre-op care only | $100.00 | $104.71 | $144.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $691.83 Median $724.44 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $691.83 | $724.44 | $1,000.00 |
Where Florida sits
The same service costs 7.1 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· 46th of 51
$1,202
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.