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 $1,230.27 Median $6,025.60 Typical High $12,022.64 | Facility | None | $1,230.27 | $6,025.60 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $1,148.15 Median $1,318.26 Typical High $1,584.89 | Professional | None | $1,148.15 | $1,318.26 | $1,584.89 |
AvMed Setting Facility Modifier None Typical Low $1,047.13 Median $3,630.78 Typical High $11,748.98 | Facility | None | $1,047.13 | $3,630.78 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $1,047.13 Median $1,380.38 Typical High $1,584.89 | Professional | None | $1,047.13 | $1,380.38 | $1,584.89 |
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 $1,000.00 Median $1,047.13 Typical High $2,187.76 | Professional | None | $1,000.00 | $1,047.13 | $2,187.76 |
Florida Blue Setting Facility Modifier None Typical Low $1,778.28 Median $3,548.13 Typical High $16,982.44 | Facility | None | $1,778.28 | $3,548.13 | $16,982.44 |
Florida Blue Setting Professional Modifier None Typical Low $575.44 Median $1,202.26 Typical High $1,412.54 | Professional | None | $575.44 | $1,202.26 | $1,412.54 |
Molina Setting Professional Modifier None Typical Low $91.20 Median $812.83 Typical High $1,513.56 | Professional | None | $91.20 | $812.83 | $1,513.56 |
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 $933.25 Median $1,202.26 Typical High $2,344.23 | Professional | None | $933.25 | $1,202.26 | $2,344.23 |
Wellpoint Setting Professional Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $1,318.26 | Professional | None | $1,000.00 | $1,000.00 | $1,318.26 |
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 $575.44 Median $660.69 Typical High $776.25 | Professional | 52 · Reduced service | $575.44 | $660.69 | $776.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $229.09 Median $263.03 Typical High $309.03 | Professional | 53 · Discontinued | $229.09 | $263.03 | $309.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $851.14 Median $977.24 Typical High $1,174.90 | Professional | 54 · Surgery only | $851.14 | $977.24 | $1,174.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $169.82 Median $199.53 Typical High $234.42 | Professional | 55 · Aftercare only | $169.82 | $199.53 | $234.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $131.83 Typical High $154.88 | Professional | 56 · Pre-op care only | $114.82 | $131.83 | $154.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $794.33 Median $912.01 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $794.33 | $912.01 | $1,096.48 |
Where Florida sits
The same service costs 19.5 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· 47th of 51
$1,148
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.