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 $1,819.70 Median $2,238.72 Typical High $2,818.38 | Professional | None | $1,819.70 | $2,238.72 | $2,818.38 |
AvMed Setting Facility Modifier None Typical Low $1,445.44 Median $2,398.83 Typical High $11,748.98 | Facility | None | $1,445.44 | $2,398.83 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $1,905.46 Median $2,398.83 Typical High $2,754.23 | Professional | None | $1,905.46 | $2,398.83 | $2,754.23 |
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 $1,659.59 Median $2,511.89 Typical High $4,897.79 | Professional | None | $1,659.59 | $2,511.89 | $4,897.79 |
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 $1,584.89 Median $1,659.59 Typical High $2,691.53 | Professional | None | $1,584.89 | $1,659.59 | $2,691.53 |
Molina Setting Professional Modifier None Typical Low $173.78 Median $1,778.28 Typical High $2,818.38 | Professional | None | $173.78 | $1,778.28 | $2,818.38 |
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 $2,691.53 Typical High $6,025.60 | Professional | None | $54.95 | $2,691.53 | $6,025.60 |
Wellpoint Setting Professional Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $2,398.83 | Professional | None | $1,621.81 | $1,621.81 | $2,398.83 |
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 $912.01 Median $1,122.02 Typical High $1,412.54 | Professional | 52 · Reduced service | $912.01 | $1,122.02 | $1,412.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $363.08 Median $446.68 Typical High $562.34 | Professional | 53 · Discontinued | $363.08 | $446.68 | $562.34 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,380.38 Median $1,698.24 Typical High $2,089.30 | Professional | 54 · Surgery only | $1,380.38 | $1,698.24 | $2,089.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $275.42 Median $338.84 Typical High $416.87 | Professional | 55 · Aftercare only | $275.42 | $338.84 | $416.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $181.97 Median $223.87 Typical High $281.84 | Professional | 56 · Pre-op care only | $181.97 | $223.87 | $281.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,288.25 Median $1,584.89 Typical High $1,949.84 | Professional | 78 · Unplanned return to OR | $1,288.25 | $1,584.89 | $1,949.84 |
Where Florida sits
The same service costs 6.2 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
$2,089
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.