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 $977.24 Median $6,309.57 Typical High $14,125.38 | Facility | None | $977.24 | $6,309.57 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $1,621.81 Median $1,862.09 Typical High $2,187.76 | Professional | None | $1,621.81 | $1,862.09 | $2,187.76 |
AvMed Setting Facility Modifier None Typical Low $1,479.11 Median $4,466.84 Typical High $13,489.63 | Facility | None | $1,479.11 | $4,466.84 | $13,489.63 |
AvMed Setting Professional Modifier None Typical Low $1,698.24 Median $2,089.30 Typical High $2,570.40 | Professional | None | $1,698.24 | $2,089.30 | $2,570.40 |
Cigna Setting Facility Modifier None Typical Low $537.03 Median $9,332.54 Typical High $18,620.87 | Facility | None | $537.03 | $9,332.54 | $18,620.87 |
Cigna Setting Professional Modifier None Typical Low $1,479.11 Median $1,621.81 Typical High $3,162.28 | Professional | None | $1,479.11 | $1,621.81 | $3,162.28 |
Florida Blue Setting Facility Modifier None Typical Low $5,623.41 Median $12,302.69 Typical High $22,908.68 | Facility | None | $5,623.41 | $12,302.69 | $22,908.68 |
Florida Blue Setting Professional Modifier None Typical Low $851.14 Median $1,905.46 Typical High $2,290.87 | Professional | None | $851.14 | $1,905.46 | $2,290.87 |
Molina Setting Professional Modifier None Typical Low $204.17 Median $1,318.26 Typical High $2,398.83 | Professional | None | $204.17 | $1,318.26 | $2,398.83 |
United Setting Facility Modifier None Typical Low $2,511.89 Median $10,232.93 Typical High $23,442.29 | Facility | None | $2,511.89 | $10,232.93 | $23,442.29 |
United Setting Professional Modifier None Typical Low $1,318.26 Median $1,737.80 Typical High $3,467.37 | Professional | None | $1,318.26 | $1,737.80 | $3,467.37 |
Wellpoint Setting Professional Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $2,089.30 | Professional | None | $1,513.56 | $1,513.56 | $2,089.30 |
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 $933.25 Typical High $1,096.48 | Professional | 52 · Reduced service | $812.83 | $933.25 | $1,096.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $331.13 Median $371.54 Typical High $436.52 | Professional | 53 · Discontinued | $331.13 | $371.54 | $436.52 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,230.27 Median $1,412.54 Typical High $1,621.81 | Professional | 54 · Surgery only | $1,230.27 | $1,412.54 | $1,621.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $245.47 Median $281.84 Typical High $323.59 | Professional | 55 · Aftercare only | $245.47 | $281.84 | $323.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $162.18 Median $186.21 Typical High $218.78 | Professional | 56 · Pre-op care only | $162.18 | $186.21 | $218.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,148.15 Median $1,318.26 Typical High $1,513.56 | Professional | 78 · Unplanned return to OR | $1,148.15 | $1,318.26 | $1,513.56 |
Where Florida sits
The same service costs 16.2 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· 48th of 51
$1,622
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.