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 $1,412.54 Median $1,513.56 Typical High $1,949.84 | Professional | None | $1,412.54 | $1,513.56 | $1,949.84 |
AvMed Setting Facility Modifier None Typical Low $1,288.25 Median $4,168.69 Typical High $11,748.98 | Facility | None | $1,288.25 | $4,168.69 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $1,288.25 Median $1,698.24 Typical High $1,995.26 | Professional | None | $1,288.25 | $1,698.24 | $1,995.26 |
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 $1,230.27 Median $1,318.26 Typical High $2,630.27 | Professional | None | $1,230.27 | $1,318.26 | $2,630.27 |
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 $724.44 Median $1,513.56 Typical High $1,905.46 | Professional | None | $724.44 | $1,513.56 | $1,905.46 |
Molina Setting Professional Modifier None Typical Low $173.78 Median $1,000.00 Typical High $1,819.70 | Professional | None | $173.78 | $1,000.00 | $1,819.70 |
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 $1,148.15 Median $1,479.11 Typical High $2,951.21 | Professional | None | $1,148.15 | $1,479.11 | $2,951.21 |
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 $707.95 Median $758.58 Typical High $912.01 | Professional | 52 · Reduced service | $707.95 | $758.58 | $912.01 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $281.84 Median $302.00 Typical High $371.54 | Professional | 53 · Discontinued | $281.84 | $302.00 | $371.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,071.52 Median $1,148.15 Typical High $1,380.38 | Professional | 54 · Surgery only | $1,071.52 | $1,148.15 | $1,380.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $213.80 Median $229.09 Typical High $275.42 | Professional | 55 · Aftercare only | $213.80 | $229.09 | $275.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $141.25 Median $151.36 Typical High $186.21 | Professional | 56 · Pre-op care only | $141.25 | $151.36 | $186.21 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,000.00 Median $1,071.52 Typical High $1,288.25 | Professional | 78 · Unplanned return to OR | $1,000.00 | $1,071.52 | $1,288.25 |
Where Florida sits
The same service costs 9.3 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
$1,413
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.