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 $1,949.84 Median $2,089.30 Typical High $2,630.27 | Professional | None | $1,949.84 | $2,089.30 | $2,630.27 |
AvMed Setting Facility Modifier None Typical Low $1,445.44 Median $2,238.72 Typical High $11,748.98 | Facility | None | $1,445.44 | $2,238.72 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $1,778.28 Median $2,238.72 Typical High $2,630.27 | Professional | None | $1,778.28 | $2,238.72 | $2,630.27 |
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 $1,548.82 Median $2,344.23 Typical High $4,677.35 | Professional | None | $1,548.82 | $2,344.23 | $4,677.35 |
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 $1,479.11 Median $1,548.82 Typical High $2,570.40 | Professional | None | $1,479.11 | $1,548.82 | $2,570.40 |
Molina Setting Professional Modifier None Typical Low $181.97 Median $1,862.09 Typical High $2,691.53 | Professional | None | $181.97 | $1,862.09 | $2,691.53 |
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 $2,511.89 Typical High $5,888.44 | Professional | None | $54.95 | $2,511.89 | $5,888.44 |
Wellpoint Setting Professional Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $2,238.72 | Professional | None | $1,513.56 | $1,513.56 | $2,238.72 |
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 $977.24 Median $1,047.13 Typical High $1,288.25 | Professional | 52 · Reduced service | $977.24 | $1,047.13 | $1,288.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $389.05 Median $416.87 Typical High $524.81 | Professional | 53 · Discontinued | $389.05 | $416.87 | $524.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,479.11 Median $1,584.89 Typical High $1,949.84 | Professional | 54 · Surgery only | $1,479.11 | $1,584.89 | $1,949.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $295.12 Median $316.23 Typical High $389.05 | Professional | 55 · Aftercare only | $295.12 | $316.23 | $389.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $194.98 Median $208.93 Typical High $263.03 | Professional | 56 · Pre-op care only | $194.98 | $208.93 | $263.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,380.38 Median $1,479.11 Typical High $1,819.70 | Professional | 78 · Unplanned return to OR | $1,380.38 | $1,479.11 | $1,819.70 |
Where Florida sits
The same service costs 5.4 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· 49th of 51
$2,042
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.