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 $3,467.37 Median $3,548.13 Typical High $4,265.80 | Professional | None | $3,467.37 | $3,548.13 | $4,265.80 |
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 $2,951.21 Median $3,890.45 Typical High $4,466.84 | Professional | None | $2,951.21 | $3,890.45 | $4,466.84 |
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 $2,884.03 Median $3,019.95 Typical High $6,165.95 | Professional | None | $2,884.03 | $3,019.95 | $6,165.95 |
Florida Blue Setting Facility Modifier None Typical Low $6,606.93 Median $12,302.69 Typical High $22,908.68 | Facility | None | $6,606.93 | $12,302.69 | $22,908.68 |
Florida Blue Setting Professional Modifier None Typical Low $1,778.28 Median $3,548.13 Typical High $4,570.88 | Professional | None | $1,778.28 | $3,548.13 | $4,570.88 |
Molina Setting Professional Modifier None Typical Low $323.59 Median $2,290.87 Typical High $4,168.69 | Professional | None | $323.59 | $2,290.87 | $4,168.69 |
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 $2,691.53 Median $3,467.37 Typical High $6,760.83 | Professional | None | $2,691.53 | $3,467.37 | $6,760.83 |
Wellpoint Setting Professional Modifier None Typical Low $2,691.53 Median $2,691.53 Typical High $3,630.78 | Professional | None | $2,691.53 | $2,691.53 | $3,630.78 |
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 $1,737.80 Median $1,778.28 Typical High $2,137.96 | Professional | 52 · Reduced service | $1,737.80 | $1,778.28 | $2,137.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $691.83 Median $707.95 Typical High $851.14 | Professional | 53 · Discontinued | $691.83 | $707.95 | $851.14 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,570.40 Median $2,691.53 Typical High $3,235.94 | Professional | 54 · Surgery only | $2,570.40 | $2,691.53 | $3,235.94 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $512.86 Median $537.03 Typical High $645.65 | Professional | 55 · Aftercare only | $512.86 | $537.03 | $645.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $346.74 Median $354.81 Typical High $426.58 | Professional | 56 · Pre-op care only | $346.74 | $354.81 | $426.58 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,398.83 Median $2,511.89 Typical High $3,019.95 | Professional | 78 · Unplanned return to OR | $2,398.83 | $2,511.89 | $3,019.95 |
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
$3,020
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.