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 $4,677.35 Typical High $12,022.64 | Facility | None | $776.25 | $4,677.35 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $3,981.07 Median $4,677.35 Typical High $4,897.79 | Professional | None | $3,981.07 | $4,677.35 | $4,897.79 |
AvMed Setting Facility Modifier None Typical Low $1,445.44 Median $4,168.69 Typical High $11,748.98 | Facility | None | $1,445.44 | $4,168.69 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $3,548.13 Median $4,265.80 Typical High $5,370.32 | Professional | None | $3,548.13 | $4,265.80 | $5,370.32 |
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 $3,311.31 Median $3,548.13 Typical High $6,606.93 | Professional | None | $3,311.31 | $3,548.13 | $6,606.93 |
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 $2,187.76 Median $3,162.28 Typical High $5,248.07 | Professional | None | $2,187.76 | $3,162.28 | $5,248.07 |
Molina Setting Professional Modifier None Typical Low $331.13 Median $3,019.95 Typical High $7,244.36 | Professional | None | $331.13 | $3,019.95 | $7,244.36 |
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 $3,162.28 Median $4,073.80 Typical High $6,760.83 | Professional | None | $3,162.28 | $4,073.80 | $6,760.83 |
Wellpoint Setting Professional Modifier None Typical Low $3,235.94 Median $3,235.94 Typical High $3,235.94 | Professional | None | $3,235.94 | $3,235.94 | $3,235.94 |
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 $1,949.84 Median $2,290.87 Typical High $2,454.71 | Professional | 52 · Reduced service | $1,949.84 | $2,290.87 | $2,454.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $794.33 Median $933.25 Typical High $977.24 | Professional | 53 · Discontinued | $794.33 | $933.25 | $977.24 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,951.21 Median $3,467.37 Typical High $3,715.35 | Professional | 54 · Surgery only | $2,951.21 | $3,467.37 | $3,715.35 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $588.84 Median $691.83 Typical High $741.31 | Professional | 55 · Aftercare only | $588.84 | $691.83 | $741.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $398.11 Median $467.74 Typical High $489.78 | Professional | 56 · Pre-op care only | $398.11 | $467.74 | $489.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,754.23 Median $3,235.94 Typical High $3,467.37 | Professional | 78 · Unplanned return to OR | $2,754.23 | $3,235.94 | $3,467.37 |
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
$3,548
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.