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 $3,162.28 Median $3,715.35 Typical High $3,981.07 | Professional | None | $3,162.28 | $3,715.35 | $3,981.07 |
AvMed Setting Facility Modifier None Typical Low $1,445.44 Median $3,388.44 Typical High $11,748.98 | Facility | None | $1,445.44 | $3,388.44 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $2,884.03 Median $3,388.44 Typical High $4,265.80 | Professional | None | $2,884.03 | $3,388.44 | $4,265.80 |
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 $2,691.53 Median $2,818.38 Typical High $5,128.61 | Professional | None | $2,691.53 | $2,818.38 | $5,128.61 |
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 $1,862.09 Median $2,570.40 Typical High $4,168.69 | Professional | None | $1,862.09 | $2,570.40 | $4,168.69 |
Molina Setting Professional Modifier None Typical Low $281.84 Median $2,454.71 Typical High $5,754.40 | Professional | None | $281.84 | $2,454.71 | $5,754.40 |
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 $2,570.40 Median $3,235.94 Typical High $5,370.32 | Professional | None | $2,570.40 | $3,235.94 | $5,370.32 |
Wellpoint Setting Professional Modifier None Typical Low $2,630.27 Median $2,630.27 Typical High $2,630.27 | Professional | None | $2,630.27 | $2,630.27 | $2,630.27 |
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 $1,584.89 Median $1,862.09 Typical High $1,995.26 | Professional | 52 · Reduced service | $1,584.89 | $1,862.09 | $1,995.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $645.65 Median $741.31 Typical High $794.33 | Professional | 53 · Discontinued | $645.65 | $741.31 | $794.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,398.83 Median $2,818.38 Typical High $3,019.95 | Professional | 54 · Surgery only | $2,398.83 | $2,818.38 | $3,019.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $478.63 Median $562.34 Typical High $602.56 | Professional | 55 · Aftercare only | $478.63 | $562.34 | $602.56 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $316.23 Median $371.54 Typical High $398.11 | Professional | 56 · Pre-op care only | $316.23 | $371.54 | $398.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,238.72 Median $2,630.27 Typical High $2,818.38 | Professional | 78 · Unplanned return to OR | $2,238.72 | $2,630.27 | $2,818.38 |
Where Florida sits
The same service costs 21.9 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· 48th of 51
$2,818
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.