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 $5,495.41 Typical High $12,302.69 | Facility | None | $776.25 | $5,495.41 | $12,302.69 |
Aetna Setting Professional Modifier None Typical Low $1,318.26 Median $1,412.54 Typical High $1,659.59 | Professional | None | $1,318.26 | $1,412.54 | $1,659.59 |
AvMed Setting Facility Modifier None Typical Low $1,202.26 Median $2,137.96 Typical High $11,748.98 | Facility | None | $1,202.26 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $1,202.26 Median $1,513.56 Typical High $1,778.28 | Professional | None | $1,202.26 | $1,513.56 | $1,778.28 |
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 $1,122.02 Median $1,202.26 Typical High $2,137.96 | Professional | None | $1,122.02 | $1,202.26 | $2,137.96 |
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 $741.31 Median $1,122.02 Typical High $1,778.28 | Professional | None | $741.31 | $1,122.02 | $1,778.28 |
Molina Setting Professional Modifier None Typical Low $128.82 Median $1,148.15 Typical High $2,630.27 | Professional | None | $128.82 | $1,148.15 | $2,630.27 |
United Setting Facility Modifier None Typical Low $1,584.89 Median $4,073.80 Typical High $15,488.17 | Facility | None | $1,584.89 | $4,073.80 | $15,488.17 |
United Setting Professional Modifier None Typical Low $1,071.52 Median $1,380.38 Typical High $2,290.87 | Professional | None | $1,071.52 | $1,380.38 | $2,290.87 |
Wellpoint Setting Professional Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $1,096.48 | Professional | None | $1,096.48 | $1,096.48 | $1,096.48 |
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 $660.69 Median $707.95 Typical High $831.76 | Professional | 52 · Reduced service | $660.69 | $707.95 | $831.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $281.84 Typical High $331.13 | Professional | 53 · Discontinued | $263.03 | $281.84 | $331.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $977.24 Median $1,047.13 Typical High $1,258.93 | Professional | 54 · Surgery only | $977.24 | $1,047.13 | $1,258.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $208.93 Typical High $251.19 | Professional | 55 · Aftercare only | $194.98 | $208.93 | $251.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $131.83 Median $141.25 Typical High $165.96 | Professional | 56 · Pre-op care only | $131.83 | $141.25 | $165.96 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $912.01 Median $977.24 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $912.01 | $977.24 | $1,174.90 |
Where Florida sits
The same service costs 6.3 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
$1,288
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.