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 $1,621.81 Median $1,621.81 Typical High $2,041.74 | Professional | None | $1,621.81 | $1,621.81 | $2,041.74 |
AvMed Setting Facility Modifier None Typical Low $831.76 Median $2,137.96 Typical High $11,748.98 | Facility | None | $831.76 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $1,380.38 Median $1,905.46 Typical High $2,238.72 | Professional | None | $1,380.38 | $1,905.46 | $2,238.72 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $1,023.29 Typical High $2,691.53 | Facility | None | $512.86 | $1,023.29 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $1,318.26 Median $1,380.38 Typical High $2,951.21 | Professional | None | $1,318.26 | $1,380.38 | $2,951.21 |
Florida Blue Setting Facility Modifier None Typical Low $724.44 Median $1,621.81 Typical High $6,309.57 | Facility | None | $724.44 | $1,621.81 | $6,309.57 |
Florida Blue Setting Professional Modifier None Typical Low $831.76 Median $1,659.59 Typical High $2,754.23 | Professional | None | $831.76 | $1,659.59 | $2,754.23 |
Molina Setting Professional Modifier None Typical Low $204.17 Median $1,096.48 Typical High $1,995.26 | Professional | None | $204.17 | $1,096.48 | $1,995.26 |
United Setting Facility Modifier None Typical Low $1,584.89 Median $4,073.80 Typical High $15,488.17 | Facility | None | $1,584.89 | $4,073.80 | $15,488.17 |
United Setting Professional Modifier None Typical Low $1,230.27 Median $1,621.81 Typical High $3,090.30 | Professional | None | $1,230.27 | $1,621.81 | $3,090.30 |
Wellpoint Setting Professional Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $1,698.24 | Professional | None | $1,288.25 | $1,288.25 | $1,698.24 |
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 $812.83 Median $812.83 Typical High $1,000.00 | Professional | 52 · Reduced service | $812.83 | $812.83 | $1,000.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $323.59 Median $323.59 Typical High $398.11 | Professional | 53 · Discontinued | $323.59 | $323.59 | $398.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,202.26 Median $1,230.27 Typical High $1,513.56 | Professional | 54 · Surgery only | $1,202.26 | $1,230.27 | $1,513.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $239.88 Median $245.47 Typical High $302.00 | Professional | 55 · Aftercare only | $239.88 | $245.47 | $302.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $162.18 Median $162.18 Typical High $199.53 | Professional | 56 · Pre-op care only | $162.18 | $162.18 | $199.53 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,122.02 Median $1,148.15 Typical High $1,412.54 | Professional | 78 · Unplanned return to OR | $1,122.02 | $1,148.15 | $1,412.54 |
Where Florida sits
The same service costs 18.6 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
$1,380
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.