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 $851.14 Median $6,025.60 Typical High $13,182.57 | Facility | None | $851.14 | $6,025.60 | $13,182.57 |
Aetna Setting Professional Modifier None Typical Low $1,202.26 Median $1,348.96 Typical High $1,949.84 | Professional | None | $1,202.26 | $1,348.96 | $1,949.84 |
AvMed Setting Facility Modifier None Typical Low $1,445.44 Median $3,467.37 Typical High $11,748.98 | Facility | None | $1,445.44 | $3,467.37 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $1,479.11 Median $1,819.70 Typical High $2,290.87 | Professional | None | $1,479.11 | $1,819.70 | $2,290.87 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $3,467.37 Typical High $6,606.93 | Facility | None | $489.78 | $3,467.37 | $6,606.93 |
Cigna Setting Professional Modifier None Typical Low $1,318.26 Median $1,445.44 Typical High $2,691.53 | Professional | None | $1,318.26 | $1,445.44 | $2,691.53 |
Florida Blue Setting Facility Modifier None Typical Low $1,318.26 Median $2,630.27 Typical High $16,982.44 | Facility | None | $1,318.26 | $2,630.27 | $16,982.44 |
Florida Blue Setting Professional Modifier None Typical Low $616.60 Median $1,445.44 Typical High $2,041.74 | Professional | None | $616.60 | $1,445.44 | $2,041.74 |
Molina Setting Professional Modifier None Typical Low $177.83 Median $1,230.27 Typical High $2,238.72 | Professional | None | $177.83 | $1,230.27 | $2,238.72 |
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 $1,096.48 Median $1,445.44 Typical High $2,951.21 | Professional | None | $1,096.48 | $1,445.44 | $2,951.21 |
Wellpoint Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,905.46 | Professional | None | $1,258.93 | $1,258.93 | $1,905.46 |
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 $602.56 Median $676.08 Typical High $954.99 | Professional | 52 · Reduced service | $602.56 | $676.08 | $954.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $239.88 Median $269.15 Typical High $389.05 | Professional | 53 · Discontinued | $239.88 | $269.15 | $389.05 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $1,023.29 Typical High $1,445.44 | Professional | 54 · Surgery only | $912.01 | $1,023.29 | $1,445.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $204.17 Typical High $288.40 | Professional | 55 · Aftercare only | $181.97 | $204.17 | $288.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $120.23 Median $134.90 Typical High $190.55 | Professional | 56 · Pre-op care only | $120.23 | $134.90 | $190.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $954.99 Typical High $1,348.96 | Professional | 78 · Unplanned return to OR | $851.14 | $954.99 | $1,348.96 |
Where Florida sits
The same service costs 11.2 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
$1,445
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.