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 $2,511.89 Median $2,818.38 Typical High $3,162.28 | Professional | None | $2,511.89 | $2,818.38 | $3,162.28 |
AvMed Setting Facility Modifier None Typical Low $1,445.44 Median $2,818.38 Typical High $11,748.98 | Facility | None | $1,445.44 | $2,818.38 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $2,290.87 Median $2,754.23 Typical High $3,311.31 | Professional | None | $2,290.87 | $2,754.23 | $3,311.31 |
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 $2,089.30 Median $2,238.72 Typical High $4,073.80 | Professional | None | $2,089.30 | $2,238.72 | $4,073.80 |
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 $1,479.11 Median $2,137.96 Typical High $3,311.31 | Professional | None | $1,479.11 | $2,137.96 | $3,311.31 |
Molina Setting Professional Modifier None Typical Low $234.42 Median $2,137.96 Typical High $4,897.79 | Professional | None | $234.42 | $2,137.96 | $4,897.79 |
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 $1,995.26 Median $2,570.40 Typical High $4,265.80 | Professional | None | $1,995.26 | $2,570.40 | $4,265.80 |
Wellpoint Setting Professional Modifier None Typical Low $2,089.30 Median $2,089.30 Typical High $2,089.30 | Professional | None | $2,089.30 | $2,089.30 | $2,089.30 |
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 $1,258.93 Median $1,412.54 Typical High $1,584.89 | Professional | 52 · Reduced service | $1,258.93 | $1,412.54 | $1,584.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $501.19 Median $562.34 Typical High $630.96 | Professional | 53 · Discontinued | $501.19 | $562.34 | $630.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,905.46 Median $2,089.30 Typical High $2,344.23 | Professional | 54 · Surgery only | $1,905.46 | $2,089.30 | $2,344.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $380.19 Median $426.58 Typical High $467.74 | Professional | 55 · Aftercare only | $380.19 | $426.58 | $467.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $251.19 Median $281.84 Typical High $316.23 | Professional | 56 · Pre-op care only | $251.19 | $281.84 | $316.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,778.28 Median $1,949.84 Typical High $2,187.76 | Professional | 78 · Unplanned return to OR | $1,778.28 | $1,949.84 | $2,187.76 |
Where Florida sits
The same service costs 5.1 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
$2,399
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.