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 $1,230.27 Median $1,513.56 Typical High $1,905.46 | Professional | None | $1,230.27 | $1,513.56 | $1,905.46 |
AvMed Setting Facility Modifier None Typical Low $1,230.27 Median $2,137.96 Typical High $11,748.98 | Facility | None | $1,230.27 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $1,288.25 Median $1,621.81 Typical High $1,905.46 | Professional | None | $1,288.25 | $1,621.81 | $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 $1,071.52 Median $1,148.15 Typical High $2,041.74 | Professional | None | $1,071.52 | $1,148.15 | $2,041.74 |
Molina Setting Professional Modifier None Typical Low $104.71 Median $1,202.26 Typical High $1,905.46 | Professional | None | $104.71 | $1,202.26 | $1,905.46 |
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 $1,778.28 Typical High $4,168.69 | Professional | None | $54.95 | $1,778.28 | $4,168.69 |
Wellpoint Setting Professional Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $1,621.81 | Professional | None | $1,122.02 | $1,122.02 | $1,621.81 |
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 $616.60 Median $758.58 Typical High $933.25 | Professional | 52 · Reduced service | $616.60 | $758.58 | $933.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $245.47 Median $302.00 Typical High $380.19 | Professional | 53 · Discontinued | $245.47 | $302.00 | $380.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $1,122.02 Typical High $1,412.54 | Professional | 54 · Surgery only | $933.25 | $1,122.02 | $1,412.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $223.87 Typical High $281.84 | Professional | 55 · Aftercare only | $186.21 | $223.87 | $281.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $151.36 Typical High $190.55 | Professional | 56 · Pre-op care only | $123.03 | $151.36 | $190.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $1,047.13 Typical High $1,318.26 | Professional | 78 · Unplanned return to OR | $870.96 | $1,047.13 | $1,318.26 |
Where Florida sits
The same service costs 5.9 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
$1,413
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.