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 $851.14 Median $5,495.41 Typical High $12,882.50 | Facility | None | $851.14 | $5,495.41 | $12,882.50 |
Aetna Setting Professional Modifier None Typical Low $933.25 Median $1,096.48 Typical High $1,513.56 | Professional | None | $933.25 | $1,096.48 | $1,513.56 |
AvMed Setting Facility Modifier None Typical Low $724.44 Median $2,137.96 Typical High $9,772.37 | Facility | None | $724.44 | $2,137.96 | $9,772.37 |
AvMed Setting Professional Modifier None Typical Low $1,148.15 Median $1,348.96 Typical High $1,698.24 | Professional | None | $1,148.15 | $1,348.96 | $1,698.24 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $3,311.31 Typical High $5,370.32 | Facility | None | $707.95 | $3,311.31 | $5,370.32 |
Cigna Setting Professional Modifier None Typical Low $891.25 Median $1,258.93 Typical High $2,454.71 | Professional | None | $891.25 | $1,258.93 | $2,454.71 |
Florida Blue Setting Facility Modifier None Typical Low $1,737.80 Median $3,548.13 Typical High $16,982.44 | Facility | None | $1,737.80 | $3,548.13 | $16,982.44 |
Florida Blue Setting Professional Modifier None Typical Low $977.24 Median $1,148.15 Typical High $1,548.82 | Professional | None | $977.24 | $1,148.15 | $1,548.82 |
Molina Setting Professional Modifier None Typical Low $134.90 Median $1,258.93 Typical High $2,818.38 | Professional | None | $134.90 | $1,258.93 | $2,818.38 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $3,311.31 Typical High $12,589.25 | Facility | None | $1,230.27 | $3,311.31 | $12,589.25 |
United Setting Professional Modifier None Typical Low $891.25 Median $1,445.44 Typical High $2,754.23 | Professional | None | $891.25 | $1,445.44 | $2,754.23 |
Wellpoint Setting Professional Modifier None Typical Low $831.76 Median $1,258.93 Typical High $1,258.93 | Professional | None | $831.76 | $1,258.93 | $1,258.93 |
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 $467.74 Median $549.54 Typical High $758.58 | Professional | 52 · Reduced service | $467.74 | $549.54 | $758.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $186.21 Median $218.78 Typical High $302.00 | Professional | 53 · Discontinued | $186.21 | $218.78 | $302.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $831.76 Typical High $1,122.02 | Professional | 54 · Surgery only | $707.95 | $831.76 | $1,122.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $165.96 Typical High $223.87 | Professional | 55 · Aftercare only | $141.25 | $165.96 | $223.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $109.65 Typical High $151.36 | Professional | 56 · Pre-op care only | $93.33 | $109.65 | $151.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $660.69 Median $776.25 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $660.69 | $776.25 | $1,047.13 |
Where Florida sits
The same service costs 5.2 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· 45th 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.