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 $1,513.56 Median $1,778.28 Typical High $2,089.30 | Professional | None | $1,513.56 | $1,778.28 | $2,089.30 |
AvMed Setting Facility Modifier None Typical Low $1,288.25 Median $2,137.96 Typical High $11,748.98 | Facility | None | $1,288.25 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $1,380.38 Median $1,819.70 Typical High $2,137.96 | Professional | None | $1,380.38 | $1,819.70 | $2,137.96 |
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 $1,202.26 Median $1,819.70 Typical High $3,801.89 | Professional | None | $1,202.26 | $1,819.70 | $3,801.89 |
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 $1,819.70 | Professional | None | $1,122.02 | $1,174.90 | $1,819.70 |
Molina Setting Professional Modifier None Typical Low $114.82 Median $1,288.25 Typical High $1,995.26 | Professional | None | $114.82 | $1,288.25 | $1,995.26 |
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 $1,995.26 Typical High $4,897.79 | Professional | None | $54.95 | $1,995.26 | $4,897.79 |
Wellpoint Setting Professional Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $1,698.24 | Professional | None | $1,148.15 | $1,148.15 | $1,698.24 |
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 $758.58 Median $870.96 Typical High $1,023.29 | Professional | 52 · Reduced service | $758.58 | $870.96 | $1,023.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $302.00 Median $346.74 Typical High $407.38 | Professional | 53 · Discontinued | $302.00 | $346.74 | $407.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,148.15 Median $1,318.26 Typical High $1,513.56 | Professional | 54 · Surgery only | $1,148.15 | $1,318.26 | $1,513.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $229.09 Median $263.03 Typical High $302.00 | Professional | 55 · Aftercare only | $229.09 | $263.03 | $302.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $151.36 Median $173.78 Typical High $204.17 | Professional | 56 · Pre-op care only | $151.36 | $173.78 | $204.17 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,071.52 Median $1,230.27 Typical High $1,412.54 | Professional | 78 · Unplanned return to OR | $1,071.52 | $1,230.27 | $1,412.54 |
Where Florida sits
The same service costs 5.8 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
$1,514
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.