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 $1,000.00 Median $5,495.41 Typical High $12,589.25 | Facility | None | $1,000.00 | $5,495.41 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $1,380.38 Median $1,479.11 Typical High $1,949.84 | Professional | None | $1,380.38 | $1,479.11 | $1,949.84 |
Ambetter Setting Professional Modifier None Typical Low $2,137.96 Median $2,137.96 Typical High $2,137.96 | Professional | None | $2,137.96 | $2,137.96 | $2,137.96 |
AvMed Setting Facility Modifier None Typical Low $1,258.93 Median $3,467.37 Typical High $12,882.50 | Facility | None | $1,258.93 | $3,467.37 | $12,882.50 |
AvMed Setting Professional Modifier None Typical Low $1,258.93 Median $1,659.59 Typical High $1,949.84 | Professional | None | $1,258.93 | $1,659.59 | $1,949.84 |
Cigna Setting Facility Modifier None Typical Low $537.03 Median $4,466.84 Typical High $11,481.54 | Facility | None | $537.03 | $4,466.84 | $11,481.54 |
Cigna Setting Professional Modifier None Typical Low $1,202.26 Median $1,288.25 Typical High $2,570.40 | Professional | None | $1,202.26 | $1,288.25 | $2,570.40 |
Florida Blue Setting Facility Modifier None Typical Low $1,778.28 Median $3,548.13 Typical High $16,982.44 | Facility | None | $1,778.28 | $3,548.13 | $16,982.44 |
Florida Blue Setting Professional Modifier None Typical Low $707.95 Median $1,479.11 Typical High $1,819.70 | Professional | None | $707.95 | $1,479.11 | $1,819.70 |
Molina Setting Professional Modifier None Typical Low $177.83 Median $1,000.00 Typical High $1,819.70 | Professional | None | $177.83 | $1,000.00 | $1,819.70 |
United Setting Facility Modifier None Typical Low $1,621.81 Median $4,570.88 Typical High $15,488.17 | Facility | None | $1,621.81 | $4,570.88 | $15,488.17 |
United Setting Professional Modifier None Typical Low $1,148.15 Median $1,513.56 Typical High $2,884.03 | Professional | None | $1,148.15 | $1,513.56 | $2,884.03 |
Wellpoint Setting Professional Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $1,584.89 | Professional | None | $1,174.90 | $1,174.90 | $1,584.89 |
4 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 54 · Surgery only Typical Low $1,023.29 Median $1,122.02 Typical High $1,348.96 | Professional | 54 · Surgery only | $1,023.29 | $1,122.02 | $1,348.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $223.87 Typical High $269.15 | Professional | 55 · Aftercare only | $208.93 | $223.87 | $269.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $138.04 Median $147.91 Typical High $177.83 | Professional | 56 · Pre-op care only | $138.04 | $147.91 | $177.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $954.99 Median $1,047.13 Typical High $1,258.93 | Professional | 78 · Unplanned return to OR | $954.99 | $1,047.13 | $1,258.93 |
Where Florida sits
The same service costs 7.8 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
$1,380
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.