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 $144.54 Median $229.09 Typical High $302.00 | Professional | None | $144.54 | $229.09 | $302.00 |
AvMed Setting Facility Modifier None Typical Low $234.42 Median $2,137.96 Typical High $11,748.98 | Facility | None | $234.42 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $177.83 Median $239.88 Typical High $316.23 | Professional | None | $177.83 | $239.88 | $316.23 |
Cigna Setting Facility Modifier None Typical Low $234.42 Median $446.68 Typical High $2,691.53 | Facility | None | $234.42 | $446.68 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $134.90 Median $208.93 Typical High $363.08 | Professional | None | $134.90 | $208.93 | $363.08 |
Florida Blue Setting Facility Modifier None Typical Low $199.53 Median $436.52 Typical High $7,413.10 | Facility | None | $199.53 | $436.52 | $7,413.10 |
Florida Blue Setting Professional Modifier None Typical Low $134.90 Median $223.87 Typical High $380.19 | Professional | None | $134.90 | $223.87 | $380.19 |
Molina Setting Professional Modifier None Typical Low $31.62 Median $218.78 Typical High $389.05 | Professional | None | $31.62 | $218.78 | $389.05 |
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 $138.04 Median $218.78 Typical High $407.38 | Professional | None | $138.04 | $218.78 | $407.38 |
Wellpoint Setting Professional Modifier None Typical Low $141.25 Median $281.84 Typical High $281.84 | Professional | None | $141.25 | $281.84 | $281.84 |
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 $72.44 Median $114.82 Typical High $134.90 | Professional | 52 · Reduced service | $72.44 | $114.82 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.84 Median $45.71 Typical High $54.95 | Professional | 53 · Discontinued | $28.84 | $45.71 | $54.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $109.65 Median $173.78 Typical High $204.17 | Professional | 54 · Surgery only | $109.65 | $173.78 | $204.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $34.67 Typical High $40.74 | Professional | 55 · Aftercare only | $21.88 | $34.67 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $22.91 Typical High $27.54 | Professional | 56 · Pre-op care only | $14.45 | $22.91 | $27.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $102.33 Median $162.18 Typical High $190.55 | Professional | 78 · Unplanned return to OR | $102.33 | $162.18 | $190.55 |
Where Florida sits
The same service costs 4.2 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· 49th of 51
$245
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.