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 $1,445.44 Median $6,025.60 Typical High $12,022.64 | Facility | None | $1,445.44 | $6,025.60 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $1,584.89 Median $1,778.28 Typical High $2,089.30 | Professional | None | $1,584.89 | $1,778.28 | $2,089.30 |
AvMed Setting Facility Modifier None Typical Low $1,288.25 Median $3,630.78 Typical High $11,748.98 | Facility | None | $1,288.25 | $3,630.78 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $1,288.25 Median $1,778.28 Typical High $2,089.30 | Professional | None | $1,288.25 | $1,778.28 | $2,089.30 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $3,630.78 Typical High $6,918.31 | Facility | None | $512.86 | $3,630.78 | $6,918.31 |
Cigna Setting Professional Modifier None Typical Low $1,288.25 Median $1,348.96 Typical High $2,884.03 | Professional | None | $1,288.25 | $1,348.96 | $2,884.03 |
Florida Blue Setting Facility Modifier None Typical Low $1,071.52 Median $2,238.72 Typical High $16,982.44 | Facility | None | $1,071.52 | $2,238.72 | $16,982.44 |
Florida Blue Setting Professional Modifier None Typical Low $812.83 Median $1,548.82 Typical High $1,995.26 | Professional | None | $812.83 | $1,548.82 | $1,995.26 |
Molina Setting Professional Modifier None Typical Low $120.23 Median $1,023.29 Typical High $1,819.70 | Professional | None | $120.23 | $1,023.29 | $1,819.70 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $3,311.31 Typical High $12,589.25 | Facility | None | $1,230.27 | $3,311.31 | $12,589.25 |
United Setting Professional Modifier None Typical Low $1,202.26 Median $1,584.89 Typical High $3,090.30 | Professional | None | $1,202.26 | $1,584.89 | $3,090.30 |
Wellpoint Setting Professional Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $1,584.89 | Professional | None | $1,202.26 | $1,202.26 | $1,584.89 |
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 $794.33 Median $891.25 Typical High $1,023.29 | Professional | 52 · Reduced service | $794.33 | $891.25 | $1,023.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $316.23 Median $354.81 Typical High $416.87 | Professional | 53 · Discontinued | $316.23 | $354.81 | $416.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,174.90 Median $1,348.96 Typical High $1,548.82 | Professional | 54 · Surgery only | $1,174.90 | $1,348.96 | $1,548.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $234.42 Median $269.15 Typical High $309.03 | Professional | 55 · Aftercare only | $234.42 | $269.15 | $309.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $158.49 Median $177.83 Typical High $208.93 | Professional | 56 · Pre-op care only | $158.49 | $177.83 | $208.93 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,096.48 Median $1,258.93 Typical High $1,445.44 | Professional | 78 · Unplanned return to OR | $1,096.48 | $1,258.93 | $1,445.44 |
Where Florida sits
The same service costs 20.0 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
$1,349
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.