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 $707.95 Median $4,073.80 Typical High $11,481.54 | Facility | None | $707.95 | $4,073.80 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $1,258.93 Median $1,412.54 Typical High $1,819.70 | Professional | None | $1,258.93 | $1,412.54 | $1,819.70 |
AvMed Setting Facility Modifier None Typical Low $512.86 Median $1,698.24 Typical High $9,549.93 | Facility | None | $512.86 | $1,698.24 | $9,549.93 |
AvMed Setting Professional Modifier None Typical Low $1,258.93 Median $1,584.89 Typical High $1,862.09 | Professional | None | $1,258.93 | $1,584.89 | $1,862.09 |
Cigna Setting Facility Modifier None Typical Low $436.52 Median $1,862.09 Typical High $2,884.03 | Facility | None | $436.52 | $1,862.09 | $2,884.03 |
Cigna Setting Professional Modifier None Typical Low $1,202.26 Median $1,258.93 Typical High $2,454.71 | Professional | None | $1,202.26 | $1,258.93 | $2,454.71 |
Florida Blue Setting Facility Modifier None Typical Low $1,230.27 Median $2,630.27 Typical High $16,982.44 | Facility | None | $1,230.27 | $2,630.27 | $16,982.44 |
Florida Blue Setting Professional Modifier None Typical Low $630.96 Median $1,412.54 Typical High $1,737.80 | Professional | None | $630.96 | $1,412.54 | $1,737.80 |
Molina Setting Professional Modifier None Typical Low $123.03 Median $1,023.29 Typical High $1,862.09 | Professional | None | $123.03 | $1,023.29 | $1,862.09 |
United Setting Facility Modifier None Typical Low $954.99 Median $2,344.23 Typical High $10,000.00 | Facility | None | $954.99 | $2,344.23 | $10,000.00 |
United Setting Professional Modifier None Typical Low $1,071.52 Median $1,380.38 Typical High $2,691.53 | Professional | None | $1,071.52 | $1,380.38 | $2,691.53 |
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 $616.60 Median $707.95 Typical High $870.96 | Professional | 52 · Reduced service | $616.60 | $707.95 | $870.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $251.19 Median $281.84 Typical High $346.74 | Professional | 53 · Discontinued | $251.19 | $281.84 | $346.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $1,071.52 Typical High $1,318.26 | Professional | 54 · Surgery only | $933.25 | $1,071.52 | $1,318.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $213.80 Typical High $263.03 | Professional | 55 · Aftercare only | $186.21 | $213.80 | $263.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $125.89 Median $141.25 Typical High $173.78 | Professional | 56 · Pre-op care only | $125.89 | $141.25 | $173.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $1,000.00 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $870.96 | $1,000.00 | $1,230.27 |
Where Florida sits
The same service costs 7.8 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
$1,288
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.