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 $4,897.79 Typical High $12,882.50 | Facility | None | $851.14 | $4,897.79 | $12,882.50 |
Aetna Setting Professional Modifier None Typical Low $1,047.13 Median $1,174.90 Typical High $1,513.56 | Professional | None | $1,047.13 | $1,174.90 | $1,513.56 |
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 $1,096.48 Median $1,380.38 Typical High $1,584.89 | Professional | None | $1,096.48 | $1,380.38 | $1,584.89 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $1,023.29 Typical High $3,801.89 | Facility | None | $691.83 | $1,023.29 | $3,801.89 |
Cigna Setting Professional Modifier None Typical Low $1,047.13 Median $1,096.48 Typical High $2,137.96 | Professional | None | $1,047.13 | $1,096.48 | $2,137.96 |
Florida Blue Setting Facility Modifier None Typical Low $616.60 Median $1,348.96 Typical High $6,309.57 | Facility | None | $616.60 | $1,348.96 | $6,309.57 |
Florida Blue Setting Professional Modifier None Typical Low $537.03 Median $1,202.26 Typical High $1,479.11 | Professional | None | $537.03 | $1,202.26 | $1,479.11 |
Molina Setting Professional Modifier None Typical Low $123.03 Median $891.25 Typical High $1,584.89 | Professional | None | $123.03 | $891.25 | $1,584.89 |
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 $912.01 Median $1,202.26 Typical High $2,344.23 | Professional | None | $912.01 | $1,202.26 | $2,344.23 |
Wellpoint Setting Professional Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $1,380.38 | Professional | None | $1,047.13 | $1,047.13 | $1,380.38 |
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 $524.81 Median $588.84 Typical High $758.58 | Professional | 52 · Reduced service | $524.81 | $588.84 | $758.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $208.93 Median $234.42 Typical High $302.00 | Professional | 53 · Discontinued | $208.93 | $234.42 | $302.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $794.33 Median $870.96 Typical High $1,122.02 | Professional | 54 · Surgery only | $794.33 | $870.96 | $1,122.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $173.78 Typical High $229.09 | Professional | 55 · Aftercare only | $158.49 | $173.78 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $104.71 Median $117.49 Typical High $151.36 | Professional | 56 · Pre-op care only | $104.71 | $117.49 | $151.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $741.31 Median $812.83 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $741.31 | $812.83 | $1,047.13 |
Where Florida sits
The same service costs 17.0 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
$1,096
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.