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 $1,096.48 Median $1,148.15 Typical High $1,445.44 | Professional | None | $1,096.48 | $1,148.15 | $1,445.44 |
AvMed Setting Facility Modifier None Typical Low $1,000.00 Median $2,137.96 Typical High $13,182.57 | Facility | None | $1,000.00 | $2,137.96 | $13,182.57 |
AvMed Setting Professional Modifier None Typical Low $1,047.13 Median $1,318.26 Typical High $1,513.56 | Professional | None | $1,047.13 | $1,318.26 | $1,513.56 |
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 $912.01 Median $1,258.93 Typical High $2,570.40 | Professional | None | $912.01 | $1,258.93 | $2,570.40 |
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 $870.96 Median $933.25 Typical High $1,445.44 | Professional | None | $870.96 | $933.25 | $1,445.44 |
Molina Setting Professional Modifier None Typical Low $147.91 Median $912.01 Typical High $1,905.46 | Professional | None | $147.91 | $912.01 | $1,905.46 |
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 $1,380.38 Typical High $2,691.53 | Professional | None | $60.26 | $1,380.38 | $2,691.53 |
Wellpoint Setting Professional Modifier None Typical Low $912.01 Median $912.01 Typical High $1,258.93 | Professional | None | $912.01 | $912.01 | $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 $549.54 Median $575.44 Typical High $724.44 | Professional | 52 · Reduced service | $549.54 | $575.44 | $724.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $218.78 Median $229.09 Typical High $288.40 | Professional | 53 · Discontinued | $218.78 | $229.09 | $288.40 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $870.96 Typical High $1,071.52 | Professional | 54 · Surgery only | $812.83 | $870.96 | $1,071.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $173.78 Typical High $213.80 | Professional | 55 · Aftercare only | $165.96 | $173.78 | $213.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $114.82 Typical High $144.54 | Professional | 56 · Pre-op care only | $109.65 | $114.82 | $144.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $812.83 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $758.58 | $812.83 | $1,000.00 |
Where Florida sits
The same service costs 6.8 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· 48th of 51
$1,096
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.