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 $2,238.72 Median $2,570.40 Typical High $2,818.38 | Professional | None | $2,238.72 | $2,570.40 | $2,818.38 |
AvMed Setting Facility Modifier None Typical Low $1,479.11 Median $4,365.16 Typical High $13,182.57 | Facility | None | $1,479.11 | $4,365.16 | $13,182.57 |
AvMed Setting Professional Modifier None Typical Low $1,862.09 Median $2,570.40 Typical High $3,090.30 | Professional | None | $1,862.09 | $2,570.40 | $3,090.30 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $8,709.64 Typical High $16,595.87 | Facility | None | $512.86 | $8,709.64 | $16,595.87 |
Cigna Setting Professional Modifier None Typical Low $1,778.28 Median $1,905.46 Typical High $4,073.80 | Professional | None | $1,778.28 | $1,905.46 | $4,073.80 |
Florida Blue Setting Facility Modifier None Typical Low $5,495.41 Median $12,302.69 Typical High $22,908.68 | Facility | None | $5,495.41 | $12,302.69 | $22,908.68 |
Florida Blue Setting Professional Modifier None Typical Low $1,230.27 Median $2,238.72 Typical High $2,818.38 | Professional | None | $1,230.27 | $2,238.72 | $2,818.38 |
Molina Setting Professional Modifier None Typical Low $229.09 Median $1,584.89 Typical High $2,691.53 | Professional | None | $229.09 | $1,584.89 | $2,691.53 |
United Setting Facility Modifier None Typical Low $2,511.89 Median $10,000.00 Typical High $19,498.45 | Facility | None | $2,511.89 | $10,000.00 | $19,498.45 |
United Setting Professional Modifier None Typical Low $1,698.24 Median $2,290.87 Typical High $4,365.16 | Professional | None | $1,698.24 | $2,290.87 | $4,365.16 |
Wellpoint Setting Professional Modifier None Typical Low $1,698.24 Median $1,698.24 Typical High $2,290.87 | Professional | None | $1,698.24 | $1,698.24 | $2,290.87 |
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 $1,122.02 Median $1,258.93 Typical High $1,412.54 | Professional | 52 · Reduced service | $1,122.02 | $1,258.93 | $1,412.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $446.68 Median $512.86 Typical High $562.34 | Professional | 53 · Discontinued | $446.68 | $512.86 | $562.34 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,659.59 Median $1,905.46 Typical High $2,089.30 | Professional | 54 · Surgery only | $1,659.59 | $1,905.46 | $2,089.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $338.84 Median $380.19 Typical High $426.58 | Professional | 55 · Aftercare only | $338.84 | $380.19 | $426.58 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $223.87 Median $257.04 Typical High $281.84 | Professional | 56 · Pre-op care only | $223.87 | $257.04 | $281.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,548.82 Median $1,778.28 Typical High $1,949.84 | Professional | 78 · Unplanned return to OR | $1,548.82 | $1,778.28 | $1,949.84 |
Where Florida sits
The same service costs 25.7 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
$1,995
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.