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 $1,412.54 Median $1,445.44 Typical High $1,905.46 | Professional | None | $1,412.54 | $1,445.44 | $1,905.46 |
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 $1,318.26 Median $1,659.59 Typical High $1,905.46 | Professional | None | $1,318.26 | $1,659.59 | $1,905.46 |
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 $1,122.02 Median $1,698.24 Typical High $3,311.31 | Professional | None | $1,122.02 | $1,698.24 | $3,311.31 |
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 $1,096.48 Median $1,148.15 Typical High $2,137.96 | Professional | None | $1,096.48 | $1,148.15 | $2,137.96 |
Molina Setting Professional Modifier None Typical Low $104.71 Median $1,230.27 Typical High $1,949.84 | Professional | None | $104.71 | $1,230.27 | $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 $1,819.70 Typical High $4,073.80 | Professional | None | $54.95 | $1,819.70 | $4,073.80 |
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 |
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 $707.95 Median $724.44 Typical High $954.99 | Professional | 52 · Reduced service | $707.95 | $724.44 | $954.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $281.84 Median $288.40 Typical High $380.19 | Professional | 53 · Discontinued | $281.84 | $288.40 | $380.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,047.13 Median $1,096.48 Typical High $1,412.54 | Professional | 54 · Surgery only | $1,047.13 | $1,096.48 | $1,412.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $218.78 Typical High $281.84 | Professional | 55 · Aftercare only | $208.93 | $218.78 | $281.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $141.25 Median $144.54 Typical High $190.55 | Professional | 56 · Pre-op care only | $141.25 | $144.54 | $190.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $977.24 Median $1,023.29 Typical High $1,318.26 | Professional | 78 · Unplanned return to OR | $977.24 | $1,023.29 | $1,318.26 |
Where Florida sits
The same service costs 6.0 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· 49th of 51
$1,445
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.