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 $758.58 Median $6,025.60 Typical High $12,882.50 | Facility | None | $758.58 | $6,025.60 | $12,882.50 |
Aetna Setting Professional Modifier None Typical Low $371.54 Median $389.05 Typical High $602.56 | Professional | None | $371.54 | $389.05 | $602.56 |
AvMed Setting Facility Modifier None Typical Low $457.09 Median $2,137.96 Typical High $9,772.37 | Facility | None | $457.09 | $2,137.96 | $9,772.37 |
AvMed Setting Professional Modifier None Typical Low $323.59 Median $426.58 Typical High $467.74 | Professional | None | $323.59 | $426.58 | $467.74 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $2,041.74 Typical High $3,801.89 | Facility | None | $707.95 | $2,041.74 | $3,801.89 |
Cigna Setting Professional Modifier None Typical Low $346.74 Median $363.08 Typical High $758.58 | Professional | None | $346.74 | $363.08 | $758.58 |
Florida Blue Setting Facility Modifier None Typical Low $794.33 Median $1,698.24 Typical High $16,982.44 | Facility | None | $794.33 | $1,698.24 | $16,982.44 |
Florida Blue Setting Professional Modifier None Typical Low $204.17 Median $323.59 Typical High $549.54 | Professional | None | $204.17 | $323.59 | $549.54 |
Molina Setting Professional Modifier None Typical Low $54.95 Median $309.03 Typical High $602.56 | Professional | None | $54.95 | $309.03 | $602.56 |
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 $309.03 Median $426.58 Typical High $758.58 | Professional | None | $309.03 | $426.58 | $758.58 |
Wellpoint Setting Professional Modifier None Typical Low $346.74 Median $467.74 Typical High $467.74 | Professional | None | $346.74 | $467.74 | $467.74 |
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 $186.21 Median $194.98 Typical High $269.15 | Professional | 52 · Reduced service | $186.21 | $194.98 | $269.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $79.43 Typical High $109.65 | Professional | 53 · Discontinued | $75.86 | $79.43 | $109.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $281.84 Median $295.12 Typical High $407.38 | Professional | 54 · Surgery only | $281.84 | $295.12 | $407.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $58.88 Typical High $81.28 | Professional | 55 · Aftercare only | $56.23 | $58.88 | $81.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $38.90 Typical High $54.95 | Professional | 56 · Pre-op care only | $37.15 | $38.90 | $54.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $263.03 Median $275.42 Typical High $380.19 | Professional | 78 · Unplanned return to OR | $263.03 | $275.42 | $380.19 |
Where Florida sits
The same service costs 7.9 times more in Wyoming 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· 38th of 51
$575
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.