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 $2,884.03 Median $2,951.21 Typical High $3,981.07 | Professional | None | $2,884.03 | $2,951.21 | $3,981.07 |
AvMed Setting Facility Modifier None Typical Low $1,445.44 Median $3,235.94 Typical High $12,882.50 | Facility | None | $1,445.44 | $3,235.94 | $12,882.50 |
AvMed Setting Professional Modifier None Typical Low $2,691.53 Median $3,388.44 Typical High $3,890.45 | Professional | None | $2,691.53 | $3,388.44 | $3,890.45 |
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 $2,344.23 Median $3,388.44 Typical High $6,918.31 | Professional | None | $2,344.23 | $3,388.44 | $6,918.31 |
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 $2,238.72 Median $2,398.83 Typical High $3,388.44 | Professional | None | $2,238.72 | $2,398.83 | $3,388.44 |
Molina Setting Professional Modifier None Typical Low $218.78 Median $2,511.89 Typical High $3,981.07 | Professional | None | $218.78 | $2,511.89 | $3,981.07 |
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 $54.95 Median $3,801.89 Typical High $8,511.38 | Professional | None | $54.95 | $3,801.89 | $8,511.38 |
Wellpoint Setting Professional Modifier None Typical Low $2,344.23 Median $2,344.23 Typical High $3,388.44 | Professional | None | $2,344.23 | $2,344.23 | $3,388.44 |
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 $1,445.44 Median $1,479.11 Typical High $1,995.26 | Professional | 52 · Reduced service | $1,445.44 | $1,479.11 | $1,995.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $588.84 Median $588.84 Typical High $794.33 | Professional | 53 · Discontinued | $588.84 | $588.84 | $794.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,187.76 Median $2,238.72 Typical High $2,951.21 | Professional | 54 · Surgery only | $2,187.76 | $2,238.72 | $2,951.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $436.52 Median $446.68 Typical High $588.84 | Professional | 55 · Aftercare only | $436.52 | $446.68 | $588.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $288.40 Median $295.12 Typical High $398.11 | Professional | 56 · Pre-op care only | $288.40 | $295.12 | $398.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,041.74 Median $2,089.30 Typical High $2,754.23 | Professional | 78 · Unplanned return to OR | $2,041.74 | $2,089.30 | $2,754.23 |
Where Florida sits
The same service costs 6.3 times more in Alaska than in Arkansas. 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
$2,818
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.