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 $1,412.54 Median $6,025.60 Typical High $12,022.64 | Facility | None | $1,412.54 | $6,025.60 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $1,348.96 Median $1,412.54 Typical High $1,698.24 | Professional | None | $1,348.96 | $1,412.54 | $1,698.24 |
AvMed Setting Facility Modifier None Typical Low $691.83 Median $2,137.96 Typical High $9,772.37 | Facility | None | $691.83 | $2,137.96 | $9,772.37 |
AvMed Setting Professional Modifier None Typical Low $1,318.26 Median $1,659.59 Typical High $1,905.46 | Professional | None | $1,318.26 | $1,659.59 | $1,905.46 |
Cigna Setting Facility Modifier None Typical Low $616.60 Median $2,238.72 Typical High $3,467.37 | Facility | None | $616.60 | $2,238.72 | $3,467.37 |
Cigna Setting Professional Modifier None Typical Low $1,288.25 Median $1,445.44 Typical High $2,454.71 | Professional | None | $1,288.25 | $1,445.44 | $2,454.71 |
Florida Blue Setting Facility Modifier None Typical Low $891.25 Median $1,737.80 Typical High $16,982.44 | Facility | None | $891.25 | $1,737.80 | $16,982.44 |
Florida Blue Setting Professional Modifier None Typical Low $1,148.15 Median $1,288.25 Typical High $1,905.46 | Professional | None | $1,148.15 | $1,288.25 | $1,905.46 |
Molina Setting Professional Modifier None Typical Low $181.97 Median $1,174.90 Typical High $1,862.09 | Professional | None | $181.97 | $1,174.90 | $1,862.09 |
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 $1,000.00 Median $1,513.56 Typical High $2,691.53 | Professional | None | $1,000.00 | $1,513.56 | $2,691.53 |
Wellpoint Setting Professional Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $1,621.81 | Professional | None | $1,230.27 | $1,230.27 | $1,621.81 |
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 $676.08 Median $707.95 Typical High $812.83 | Professional | 52 · Reduced service | $676.08 | $707.95 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $269.15 Median $281.84 Typical High $323.59 | Professional | 53 · Discontinued | $269.15 | $281.84 | $323.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,000.00 Median $1,047.13 Typical High $1,202.26 | Professional | 54 · Surgery only | $1,000.00 | $1,047.13 | $1,202.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $208.93 Typical High $245.47 | Professional | 55 · Aftercare only | $199.53 | $208.93 | $245.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $134.90 Median $141.25 Typical High $162.18 | Professional | 56 · Pre-op care only | $134.90 | $141.25 | $162.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $977.24 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $933.25 | $977.24 | $1,122.02 |
Where Florida sits
The same service costs 8.7 times more in Alaska than in Texas. 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
$1,479
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.