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 $4,786.30 Typical High $12,882.50 | Facility | None | $851.14 | $4,786.30 | $12,882.50 |
Aetna Setting Professional Modifier None Typical Low $1,148.15 Median $1,318.26 Typical High $1,659.59 | Professional | None | $1,148.15 | $1,318.26 | $1,659.59 |
AvMed Setting Facility Modifier None Typical Low $724.44 Median $2,137.96 Typical High $9,772.37 | Facility | None | $724.44 | $2,137.96 | $9,772.37 |
AvMed Setting Professional Modifier None Typical Low $1,202.26 Median $1,479.11 Typical High $1,737.80 | Professional | None | $1,202.26 | $1,479.11 | $1,737.80 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $1,949.84 Typical High $3,801.89 | Facility | None | $707.95 | $1,949.84 | $3,801.89 |
Cigna Setting Professional Modifier None Typical Low $1,122.02 Median $1,174.90 Typical High $2,290.87 | Professional | None | $1,122.02 | $1,174.90 | $2,290.87 |
Florida Blue Setting Facility Modifier None Typical Low $660.69 Median $1,318.26 Typical High $16,982.44 | Facility | None | $660.69 | $1,318.26 | $16,982.44 |
Florida Blue Setting Professional Modifier None Typical Low $588.84 Median $1,318.26 Typical High $1,621.81 | Professional | None | $588.84 | $1,318.26 | $1,621.81 |
Molina Setting Professional Modifier None Typical Low $123.03 Median $933.25 Typical High $1,698.24 | Professional | None | $123.03 | $933.25 | $1,698.24 |
United Setting Facility Modifier None Typical Low $398.11 Median $1,000.00 Typical High $5,623.41 | Facility | None | $398.11 | $1,000.00 | $5,623.41 |
United Setting Professional Modifier None Typical Low $954.99 Median $1,258.93 Typical High $2,511.89 | Professional | None | $954.99 | $1,258.93 | $2,511.89 |
Wellpoint Setting Professional Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $1,479.11 | Professional | None | $1,122.02 | $1,122.02 | $1,479.11 |
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 $645.65 Typical High $812.83 | Professional | 52 · Reduced service | $575.44 | $645.65 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $263.03 Typical High $323.59 | Professional | 53 · Discontinued | $234.42 | $263.03 | $323.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $977.24 Typical High $1,230.27 | Professional | 54 · Surgery only | $870.96 | $977.24 | $1,230.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $194.98 Typical High $245.47 | Professional | 55 · Aftercare only | $173.78 | $194.98 | $245.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $131.83 Typical High $162.18 | Professional | 56 · Pre-op care only | $114.82 | $131.83 | $162.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $912.01 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $812.83 | $912.01 | $1,148.15 |
Where Florida sits
The same service costs 15.8 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· 49th of 51
$1,175
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.