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 $6,025.60 Typical High $12,882.50 | Facility | None | $851.14 | $6,025.60 | $12,882.50 |
Aetna Setting Professional Modifier None Typical Low $891.25 Median $977.24 Typical High $1,148.15 | Professional | None | $891.25 | $977.24 | $1,148.15 |
Ambetter Setting Professional Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $1,348.96 | Professional | None | $1,348.96 | $1,348.96 | $1,348.96 |
AvMed Setting Facility Modifier None Typical Low $724.44 Median $2,398.83 Typical High $9,772.37 | Facility | None | $724.44 | $2,398.83 | $9,772.37 |
AvMed Setting Professional Modifier None Typical Low $794.33 Median $1,000.00 Typical High $1,202.26 | Professional | None | $794.33 | $1,000.00 | $1,202.26 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $3,311.31 Typical High $5,623.41 | Facility | None | $707.95 | $3,311.31 | $5,623.41 |
Cigna Setting Professional Modifier None Typical Low $776.25 Median $812.83 Typical High $1,479.11 | Professional | None | $776.25 | $812.83 | $1,479.11 |
Florida Blue Setting Facility Modifier None Typical Low $1,778.28 Median $3,630.78 Typical High $16,982.44 | Facility | None | $1,778.28 | $3,630.78 | $16,982.44 |
Florida Blue Setting Professional Modifier None Typical Low $512.86 Median $977.24 Typical High $1,174.90 | Professional | None | $512.86 | $977.24 | $1,174.90 |
Molina Setting Professional Modifier None Typical Low $54.95 Median $758.58 Typical High $1,778.28 | Professional | None | $54.95 | $758.58 | $1,778.28 |
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 $758.58 Median $977.24 Typical High $1,584.89 | Professional | None | $758.58 | $977.24 | $1,584.89 |
Wellpoint Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $758.58 | Professional | None | $758.58 | $758.58 | $758.58 |
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 $446.68 Median $489.78 Typical High $575.44 | Professional | 52 · Reduced service | $446.68 | $489.78 | $575.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $194.98 Typical High $229.09 | Professional | 53 · Discontinued | $177.83 | $194.98 | $229.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $741.31 Typical High $870.96 | Professional | 54 · Surgery only | $660.69 | $741.31 | $870.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $147.91 Typical High $173.78 | Professional | 55 · Aftercare only | $131.83 | $147.91 | $173.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $97.72 Typical High $114.82 | Professional | 56 · Pre-op care only | $89.13 | $97.72 | $114.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $691.83 Typical High $812.83 | Professional | 78 · Unplanned return to OR | $616.60 | $691.83 | $812.83 |
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· 49th of 51
$891
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.