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 $3,890.45 Typical High $12,022.64 | Facility | None | $776.25 | $3,890.45 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $1,122.02 Median $1,230.27 Typical High $1,659.59 | Professional | None | $1,122.02 | $1,230.27 | $1,659.59 |
AvMed Setting Facility Modifier None Typical Low $1,122.02 Median $2,137.96 Typical High $13,182.57 | Facility | None | $1,122.02 | $2,137.96 | $13,182.57 |
AvMed Setting Professional Modifier None Typical Low $1,202.26 Median $1,479.11 Typical High $1,698.24 | Professional | None | $1,202.26 | $1,479.11 | $1,698.24 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $501.19 Typical High $2,691.53 | Facility | None | $398.11 | $501.19 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $1,023.29 Median $1,445.44 Typical High $2,691.53 | Professional | None | $1,023.29 | $1,445.44 | $2,691.53 |
Florida Blue Setting Facility Modifier None Typical Low $10,471.29 Median $22,387.21 Typical High $33,884.42 | Facility | None | $10,471.29 | $22,387.21 | $33,884.42 |
Florida Blue Setting Professional Modifier None Typical Low $977.24 Median $1,047.13 Typical High $1,737.80 | Professional | None | $977.24 | $1,047.13 | $1,737.80 |
Molina Setting Professional Modifier None Typical Low $147.91 Median $1,023.29 Typical High $2,187.76 | Professional | None | $147.91 | $1,023.29 | $2,187.76 |
United Setting Facility Modifier None Typical Low $371.54 Median $954.99 Typical High $7,585.78 | Facility | None | $371.54 | $954.99 | $7,585.78 |
United Setting Professional Modifier None Typical Low $60.26 Median $1,548.82 Typical High $2,951.21 | Professional | None | $60.26 | $1,548.82 | $2,951.21 |
Wellpoint Setting Professional Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $1,412.54 | Professional | None | $1,023.29 | $1,023.29 | $1,412.54 |
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 $562.34 Median $616.60 Typical High $812.83 | Professional | 52 · Reduced service | $562.34 | $616.60 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $245.47 Typical High $323.59 | Professional | 53 · Discontinued | $223.87 | $245.47 | $323.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $851.14 Median $933.25 Typical High $1,230.27 | Professional | 54 · Surgery only | $851.14 | $933.25 | $1,230.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $169.82 Median $186.21 Typical High $245.47 | Professional | 55 · Aftercare only | $169.82 | $186.21 | $245.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $123.03 Typical High $162.18 | Professional | 56 · Pre-op care only | $112.20 | $123.03 | $162.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $794.33 Median $870.96 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $794.33 | $870.96 | $1,148.15 |
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· 48th of 51
$1,202
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.