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 $776.25 Median $5,495.41 Typical High $12,302.69 | Facility | None | $776.25 | $5,495.41 | $12,302.69 |
Aetna Setting Professional Modifier None Typical Low $2,630.27 Median $2,818.38 Typical High $3,548.13 | Professional | None | $2,630.27 | $2,818.38 | $3,548.13 |
AvMed Setting Facility Modifier None Typical Low $1,445.44 Median $4,265.80 Typical High $13,803.84 | Facility | None | $1,445.44 | $4,265.80 | $13,803.84 |
AvMed Setting Professional Modifier None Typical Low $2,454.71 Median $3,090.30 Typical High $3,715.35 | Professional | None | $2,454.71 | $3,090.30 | $3,715.35 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $13,182.57 Typical High $25,118.86 | Facility | None | $512.86 | $13,182.57 | $25,118.86 |
Cigna Setting Professional Modifier None Typical Low $2,344.23 Median $2,511.89 Typical High $5,011.87 | Professional | None | $2,344.23 | $2,511.89 | $5,011.87 |
Florida Blue Setting Facility Modifier None Typical Low $6,918.31 Median $15,848.93 Typical High $22,908.68 | Facility | None | $6,918.31 | $15,848.93 | $22,908.68 |
Florida Blue Setting Professional Modifier None Typical Low $1,348.96 Median $2,884.03 Typical High $4,073.80 | Professional | None | $1,348.96 | $2,884.03 | $4,073.80 |
Molina Setting Professional Modifier None Typical Low $295.12 Median $1,905.46 Typical High $3,467.37 | Professional | None | $295.12 | $1,905.46 | $3,467.37 |
United Setting Facility Modifier None Typical Low $2,511.89 Median $10,000.00 Typical High $19,498.45 | Facility | None | $2,511.89 | $10,000.00 | $19,498.45 |
United Setting Professional Modifier None Typical Low $2,137.96 Median $2,754.23 Typical High $5,623.41 | Professional | None | $2,137.96 | $2,754.23 | $5,623.41 |
Wellpoint Setting Professional Modifier None Typical Low $2,238.72 Median $2,238.72 Typical High $3,019.95 | Professional | None | $2,238.72 | $2,238.72 | $3,019.95 |
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 $1,318.26 Median $1,412.54 Typical High $1,778.28 | Professional | 52 · Reduced service | $1,318.26 | $1,412.54 | $1,778.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $524.81 Median $562.34 Typical High $707.95 | Professional | 53 · Discontinued | $524.81 | $562.34 | $707.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,949.84 Median $2,089.30 Typical High $2,630.27 | Professional | 54 · Surgery only | $1,949.84 | $2,089.30 | $2,630.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $389.05 Median $416.87 Typical High $524.81 | Professional | 55 · Aftercare only | $389.05 | $416.87 | $524.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $263.03 Median $281.84 Typical High $354.81 | Professional | 56 · Pre-op care only | $263.03 | $281.84 | $354.81 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,819.70 Median $1,949.84 Typical High $2,454.71 | Professional | 78 · Unplanned return to OR | $1,819.70 | $1,949.84 | $2,454.71 |
Where Florida sits
The same service costs 20.4 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· 48th of 51
$2,512
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.