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 $776.25 Median $5,495.41 Typical High $12,302.69 | Facility | None | $776.25 | $5,495.41 | $12,302.69 |
Aetna Setting Professional Modifier None Typical Low $1,318.26 Median $1,445.44 Typical High $1,778.28 | Professional | None | $1,318.26 | $1,445.44 | $1,778.28 |
Ambetter Setting Professional Modifier None Typical Low $2,290.87 Median $2,290.87 Typical High $2,290.87 | Professional | None | $2,290.87 | $2,290.87 | $2,290.87 |
AvMed Setting Facility Modifier None Typical Low $1,230.27 Median $4,265.80 Typical High $13,182.57 | Facility | None | $1,230.27 | $4,265.80 | $13,182.57 |
AvMed Setting Professional Modifier None Typical Low $1,230.27 Median $1,621.81 Typical High $1,862.09 | Professional | None | $1,230.27 | $1,621.81 | $1,862.09 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $8,709.64 Typical High $16,595.87 | Facility | None | $512.86 | $8,709.64 | $16,595.87 |
Cigna Setting Professional Modifier None Typical Low $1,174.90 Median $1,258.93 Typical High $2,511.89 | Professional | None | $1,174.90 | $1,258.93 | $2,511.89 |
Florida Blue Setting Facility Modifier None Typical Low $5,495.41 Median $14,454.40 Typical High $22,908.68 | Facility | None | $5,495.41 | $14,454.40 | $22,908.68 |
Florida Blue Setting Professional Modifier None Typical Low $676.08 Median $1,445.44 Typical High $1,819.70 | Professional | None | $676.08 | $1,445.44 | $1,819.70 |
Molina Setting Professional Modifier None Typical Low $147.91 Median $977.24 Typical High $1,778.28 | Professional | None | $147.91 | $977.24 | $1,778.28 |
United Setting Facility Modifier None Typical Low $2,511.89 Median $10,000.00 Typical High $19,498.45 | Facility | None | $2,511.89 | $10,000.00 | $19,498.45 |
United Setting Professional Modifier None Typical Low $1,096.48 Median $1,412.54 Typical High $2,754.23 | Professional | None | $1,096.48 | $1,412.54 | $2,754.23 |
Wellpoint Setting Professional Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $1,513.56 | Professional | None | $1,148.15 | $1,148.15 | $1,513.56 |
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 $660.69 Median $724.44 Typical High $870.96 | Professional | 52 · Reduced service | $660.69 | $724.44 | $870.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $288.40 Typical High $346.74 | Professional | 53 · Discontinued | $263.03 | $288.40 | $346.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $977.24 Median $1,096.48 Typical High $1,318.26 | Professional | 54 · Surgery only | $977.24 | $1,096.48 | $1,318.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $218.78 Typical High $263.03 | Professional | 55 · Aftercare only | $199.53 | $218.78 | $263.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $131.83 Median $144.54 Typical High $173.78 | Professional | 56 · Pre-op care only | $131.83 | $144.54 | $173.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $912.01 Median $1,023.29 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $912.01 | $1,023.29 | $1,230.27 |
Where Florida sits
The same service costs 20.4 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.