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 $6,025.60 Typical High $13,182.57 | Facility | None | $851.14 | $6,025.60 | $13,182.57 |
Aetna Setting Professional Modifier None Typical Low $1,288.25 Median $1,445.44 Typical High $1,737.80 | Professional | None | $1,288.25 | $1,445.44 | $1,737.80 |
AvMed Setting Facility Modifier None Typical Low $1,202.26 Median $4,168.69 Typical High $11,748.98 | Facility | None | $1,202.26 | $4,168.69 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $1,202.26 Median $1,584.89 Typical High $1,819.70 | Professional | None | $1,202.26 | $1,584.89 | $1,819.70 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $4,365.16 Typical High $8,317.64 | Facility | None | $512.86 | $4,365.16 | $8,317.64 |
Cigna Setting Professional Modifier None Typical Low $1,148.15 Median $1,202.26 Typical High $2,454.71 | Professional | None | $1,148.15 | $1,202.26 | $2,454.71 |
Florida Blue Setting Facility Modifier None Typical Low $2,818.38 Median $5,495.41 Typical High $16,982.44 | Facility | None | $2,818.38 | $5,495.41 | $16,982.44 |
Florida Blue Setting Professional Modifier None Typical Low $660.69 Median $1,380.38 Typical High $1,778.28 | Professional | None | $660.69 | $1,380.38 | $1,778.28 |
Molina Setting Professional Modifier None Typical Low $147.91 Median $912.01 Typical High $1,737.80 | Professional | None | $147.91 | $912.01 | $1,737.80 |
United Setting Facility Modifier None Typical Low $1,584.89 Median $4,073.80 Typical High $15,488.17 | Facility | None | $1,584.89 | $4,073.80 | $15,488.17 |
United Setting Professional Modifier None Typical Low $1,047.13 Median $1,348.96 Typical High $2,691.53 | Professional | None | $1,047.13 | $1,348.96 | $2,691.53 |
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 $645.65 Median $724.44 Typical High $851.14 | Professional | 52 · Reduced service | $645.65 | $724.44 | $851.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $257.04 Median $288.40 Typical High $338.84 | Professional | 53 · Discontinued | $257.04 | $288.40 | $338.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $954.99 Median $1,071.52 Typical High $1,288.25 | Professional | 54 · Surgery only | $954.99 | $1,071.52 | $1,288.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $190.55 Median $213.80 Typical High $257.04 | Professional | 55 · Aftercare only | $190.55 | $213.80 | $257.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $144.54 Typical High $169.82 | Professional | 56 · Pre-op care only | $128.82 | $144.54 | $169.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $891.25 Median $1,000.00 Typical High $1,202.26 | Professional | 78 · Unplanned return to OR | $891.25 | $1,000.00 | $1,202.26 |
Where Florida sits
The same service costs 8.9 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
$1,288
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.