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 $707.95 Median $4,073.80 Typical High $11,481.54 | Facility | None | $707.95 | $4,073.80 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $1,348.96 Median $1,548.82 Typical High $2,041.74 | Professional | None | $1,348.96 | $1,548.82 | $2,041.74 |
AvMed Setting Facility Modifier None Typical Low $549.54 Median $1,995.26 Typical High $9,772.37 | Facility | None | $549.54 | $1,995.26 | $9,772.37 |
AvMed Setting Professional Modifier None Typical Low $1,348.96 Median $1,659.59 Typical High $1,905.46 | Professional | None | $1,348.96 | $1,659.59 | $1,905.46 |
Cigna Setting Facility Modifier None Typical Low $436.52 Median $2,818.38 Typical High $5,370.32 | Facility | None | $436.52 | $2,818.38 | $5,370.32 |
Cigna Setting Professional Modifier None Typical Low $1,230.27 Median $1,737.80 Typical High $3,235.94 | Professional | None | $1,230.27 | $1,737.80 | $3,235.94 |
Florida Blue Setting Facility Modifier None Typical Low $1,737.80 Median $3,548.13 Typical High $16,982.44 | Facility | None | $1,737.80 | $3,548.13 | $16,982.44 |
Florida Blue Setting Professional Modifier None Typical Low $1,122.02 Median $1,202.26 Typical High $1,621.81 | Professional | None | $1,122.02 | $1,202.26 | $1,621.81 |
Molina Setting Professional Modifier None Typical Low $165.96 Median $1,202.26 Typical High $2,570.40 | Professional | None | $165.96 | $1,202.26 | $2,570.40 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $3,311.31 Typical High $12,589.25 | Facility | None | $1,230.27 | $3,311.31 | $12,589.25 |
United Setting Professional Modifier None Typical Low $60.26 Median $1,819.70 Typical High $3,630.78 | Professional | None | $60.26 | $1,819.70 | $3,630.78 |
Wellpoint Setting Professional Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $1,584.89 | Professional | None | $1,230.27 | $1,230.27 | $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 $676.08 Median $776.25 Typical High $1,000.00 | Professional | 52 · Reduced service | $676.08 | $776.25 | $1,000.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $269.15 Median $309.03 Typical High $407.38 | Professional | 53 · Discontinued | $269.15 | $309.03 | $407.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,000.00 Median $1,174.90 Typical High $1,513.56 | Professional | 54 · Surgery only | $1,000.00 | $1,174.90 | $1,513.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $234.42 Typical High $302.00 | Professional | 55 · Aftercare only | $199.53 | $234.42 | $302.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $134.90 Median $154.88 Typical High $204.17 | Professional | 56 · Pre-op care only | $134.90 | $154.88 | $204.17 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $1,096.48 Typical High $1,412.54 | Professional | 78 · Unplanned return to OR | $933.25 | $1,096.48 | $1,412.54 |
Where Florida sits
The same service costs 7.1 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· 48th of 51
$1,585
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.