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 $537.03 Median $4,365.16 Typical High $11,748.98 | Facility | None | $537.03 | $4,365.16 | $11,748.98 |
Aetna Setting Professional Modifier None Typical Low $229.09 Median $363.08 Typical High $501.19 | Professional | None | $229.09 | $363.08 | $501.19 |
AvMed Setting Facility Modifier None Typical Low $467.74 Median $1,905.46 Typical High $9,549.93 | Facility | None | $467.74 | $1,905.46 | $9,549.93 |
AvMed Setting Professional Modifier None Typical Low $245.47 Median $354.81 Typical High $489.78 | Professional | None | $245.47 | $354.81 | $489.78 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $1,288.25 Typical High $2,691.53 | Facility | None | $501.19 | $1,288.25 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $213.80 Median $323.59 Typical High $549.54 | Professional | None | $213.80 | $323.59 | $549.54 |
Florida Blue Setting Facility Modifier None Typical Low $741.31 Median $1,621.81 Typical High $7,413.10 | Facility | None | $741.31 | $1,621.81 | $7,413.10 |
Florida Blue Setting Professional Modifier None Typical Low $154.88 Median $323.59 Typical High $537.03 | Professional | None | $154.88 | $323.59 | $537.03 |
Molina Setting Professional Modifier None Typical Low $33.88 Median $288.40 Typical High $562.34 | Professional | None | $33.88 | $288.40 | $562.34 |
United Setting Facility Modifier None Typical Low $794.33 Median $1,778.28 Typical High $7,585.78 | Facility | None | $794.33 | $1,778.28 | $7,585.78 |
United Setting Professional Modifier None Typical Low $199.53 Median $323.59 Typical High $588.84 | Professional | None | $199.53 | $323.59 | $588.84 |
Wellpoint Setting Professional Modifier None Typical Low $213.80 Median $436.52 Typical High $436.52 | Professional | None | $213.80 | $436.52 | $436.52 |
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 $114.82 Median $181.97 Typical High $204.17 | Professional | 52 · Reduced service | $114.82 | $181.97 | $204.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $72.44 Typical High $81.28 | Professional | 53 · Discontinued | $45.71 | $72.44 | $81.28 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $173.78 Median $269.15 Typical High $309.03 | Professional | 54 · Surgery only | $173.78 | $269.15 | $309.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $53.70 Typical High $61.66 | Professional | 55 · Aftercare only | $34.67 | $53.70 | $61.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $36.31 Typical High $40.74 | Professional | 56 · Pre-op care only | $22.91 | $36.31 | $40.74 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $162.18 Median $251.19 Typical High $288.40 | Professional | 78 · Unplanned return to OR | $162.18 | $251.19 | $288.40 |
Where Florida sits
The same service costs 5.9 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
$389
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.