How much rates vary
Facilitymedian $2,399 · 10th to 90th $437 to $24,547Professionalmedian $1,445 · 10th to 90th $112 to $2,344
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 $1,445.44 Median $1,479.11 Typical High $2,041.74 | Professional | None | $1,445.44 | $1,479.11 | $2,041.74 |
AvMed Setting Facility Modifier None Typical Low $1,258.93 Median $2,137.96 Typical High $12,882.50 | Facility | None | $1,258.93 | $2,137.96 | $12,882.50 |
AvMed Setting Professional Modifier None Typical Low $1,348.96 Median $1,698.24 Typical High $1,949.84 | Professional | None | $1,348.96 | $1,698.24 | $1,949.84 |
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 $1,148.15 Median $1,737.80 Typical High $3,388.44 | Professional | None | $1,148.15 | $1,737.80 | $3,388.44 |
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 $1,122.02 Median $1,174.90 Typical High $2,137.96 | Professional | None | $1,122.02 | $1,174.90 | $2,137.96 |
Molina Setting Professional Modifier None Typical Low $104.71 Median $1,258.93 Typical High $1,949.84 | Professional | None | $104.71 | $1,258.93 | $1,949.84 |
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 $1,862.09 Typical High $4,168.69 | Professional | None | $54.95 | $1,862.09 | $4,168.69 |
Wellpoint Setting Professional Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $1,659.59 | Professional | None | $1,148.15 | $1,148.15 | $1,659.59 |
7 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 $707.95 Median $741.31 Typical High $954.99 | Professional | 52 · Reduced service | $707.95 | $741.31 | $954.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $288.40 Median $295.12 Typical High $389.05 | Professional | 53 · Discontinued | $288.40 | $295.12 | $389.05 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,071.52 Median $1,096.48 Typical High $1,445.44 | Professional | 54 · Surgery only | $1,071.52 | $1,096.48 | $1,445.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $213.80 Median $218.78 Typical High $288.40 | Professional | 55 · Aftercare only | $213.80 | $218.78 | $288.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $144.54 Median $147.91 Typical High $194.98 | Professional | 56 · Pre-op care only | $144.54 | $147.91 | $194.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,000.00 Median $1,023.29 Typical High $1,348.96 | Professional | 78 · Unplanned return to OR | $1,000.00 | $1,023.29 | $1,348.96 |
Ambetter Setting Professional Modifier 80 · Assistant surgeon Typical Low $331.13 Median $331.13 Typical High $331.13 | Professional | 80 · Assistant surgeon | $331.13 | $331.13 | $331.13 |
Where Florida sits
The same service costs 5.5 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
$1,479
AK $6,310TX $1,148
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.