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 $1,071.52 Median $6,025.60 Typical High $12,302.69 | Facility | None | $1,071.52 | $6,025.60 | $12,302.69 |
Aetna Setting Professional Modifier None Typical Low $1,000.00 Median $1,148.15 Typical High $1,348.96 | Professional | None | $1,000.00 | $1,148.15 | $1,348.96 |
AvMed Setting Facility Modifier None Typical Low $691.83 Median $2,137.96 Typical High $11,748.98 | Facility | None | $691.83 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $1,000.00 Median $1,258.93 Typical High $1,445.44 | Professional | None | $1,000.00 | $1,258.93 | $1,445.44 |
Cigna Setting Facility Modifier None Typical Low $616.60 Median $8,317.64 Typical High $15,848.93 | Facility | None | $616.60 | $8,317.64 | $15,848.93 |
Cigna Setting Professional Modifier None Typical Low $933.25 Median $1,000.00 Typical High $1,949.84 | Professional | None | $933.25 | $1,000.00 | $1,949.84 |
Florida Blue Setting Facility Modifier None Typical Low $1,778.28 Median $3,801.89 Typical High $16,982.44 | Facility | None | $1,778.28 | $3,801.89 | $16,982.44 |
Florida Blue Setting Professional Modifier None Typical Low $512.86 Median $1,148.15 Typical High $1,348.96 | Professional | None | $512.86 | $1,148.15 | $1,348.96 |
Molina Setting Professional Modifier None Typical Low $120.23 Median $812.83 Typical High $1,445.44 | Professional | None | $120.23 | $812.83 | $1,445.44 |
United Setting Facility Modifier None Typical Low $1,584.89 Median $4,677.35 Typical High $15,848.93 | Facility | None | $1,584.89 | $4,677.35 | $15,848.93 |
United Setting Professional Modifier None Typical Low $851.14 Median $1,096.48 Typical High $2,137.96 | Professional | None | $851.14 | $1,096.48 | $2,137.96 |
Wellpoint Setting Professional Modifier None Typical Low $933.25 Median $933.25 Typical High $1,258.93 | Professional | None | $933.25 | $933.25 | $1,258.93 |
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 $501.19 Median $562.34 Typical High $676.08 | Professional | 52 · Reduced service | $501.19 | $562.34 | $676.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $229.09 Typical High $275.42 | Professional | 53 · Discontinued | $199.53 | $229.09 | $275.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $851.14 Typical High $1,023.29 | Professional | 54 · Surgery only | $741.31 | $851.14 | $1,023.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $169.82 Typical High $204.17 | Professional | 55 · Aftercare only | $151.36 | $169.82 | $204.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $114.82 Typical High $134.90 | Professional | 56 · Pre-op care only | $100.00 | $114.82 | $134.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $691.83 Median $794.33 Typical High $954.99 | Professional | 78 · Unplanned return to OR | $691.83 | $794.33 | $954.99 |
Where Florida sits
The same service costs 7.4 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
$1,072
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.