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 $724.44 Median $4,786.30 Typical High $11,748.98 | Facility | None | $724.44 | $4,786.30 | $11,748.98 |
Aetna Setting Professional Modifier None Typical Low $724.44 Median $758.58 Typical High $1,096.48 | Professional | None | $724.44 | $758.58 | $1,096.48 |
AvMed Setting Facility Modifier None Typical Low $676.08 Median $2,089.30 Typical High $9,772.37 | Facility | None | $676.08 | $2,089.30 | $9,772.37 |
AvMed Setting Professional Modifier None Typical Low $645.65 Median $851.14 Typical High $912.01 | Professional | None | $645.65 | $851.14 | $912.01 |
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 $676.08 Median $707.95 Typical High $1,412.54 | Professional | None | $676.08 | $707.95 | $1,412.54 |
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 $380.19 Median $630.96 Typical High $977.24 | Professional | None | $380.19 | $630.96 | $977.24 |
Molina Setting Professional Modifier None Typical Low $67.61 Median $562.34 Typical High $1,071.52 | Professional | None | $67.61 | $562.34 | $1,071.52 |
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 $549.54 Median $776.25 Typical High $1,412.54 | Professional | None | $549.54 | $776.25 | $1,412.54 |
Wellpoint Setting Professional Modifier None Typical Low $660.69 Median $912.01 Typical High $912.01 | Professional | None | $660.69 | $912.01 | $912.01 |
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 $363.08 Median $380.19 Typical High $537.03 | Professional | 52 · Reduced service | $363.08 | $380.19 | $537.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $151.36 Typical High $213.80 | Professional | 53 · Discontinued | $144.54 | $151.36 | $213.80 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $575.44 Typical High $794.33 | Professional | 54 · Surgery only | $549.54 | $575.44 | $794.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $114.82 Typical High $158.49 | Professional | 55 · Aftercare only | $109.65 | $114.82 | $158.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $75.86 Typical High $107.15 | Professional | 56 · Pre-op care only | $72.44 | $75.86 | $107.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $537.03 Typical High $741.31 | Professional | 78 · Unplanned return to OR | $512.86 | $537.03 | $741.31 |
Where Florida sits
The same service costs 7.4 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· 47th of 51
$851
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.