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 $1,659.59 Median $1,659.59 Typical High $3,630.78 | Professional | None | $1,659.59 | $1,659.59 | $3,630.78 |
AvMed Setting Facility Modifier None Typical Low $1,318.26 Median $4,466.84 Typical High $13,182.57 | Facility | None | $1,318.26 | $4,466.84 | $13,182.57 |
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 $1,513.56 Median $1,621.81 Typical High $2,511.89 | Professional | None | $1,513.56 | $1,621.81 | $2,511.89 |
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 $1,096.48 Median $2,290.87 Typical High $2,570.40 | Professional | None | $1,096.48 | $2,290.87 | $2,570.40 |
Molina Setting Professional Modifier None Typical Low $39.81 Median $39.81 Typical High $39.81 | Professional | None | $39.81 | $39.81 | $39.81 |
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 $1,348.96 Median $1,778.28 Typical High $3,090.30 | Professional | None | $1,348.96 | $1,778.28 | $3,090.30 |
Wellpoint Setting Professional Modifier None Typical Low $2,041.74 Median $2,041.74 Typical High $2,041.74 | Professional | None | $2,041.74 | $2,041.74 | $2,041.74 |
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 $831.76 Median $831.76 Typical High $1,819.70 | Professional | 52 · Reduced service | $831.76 | $831.76 | $1,819.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $331.13 Median $331.13 Typical High $724.44 | Professional | 53 · Discontinued | $331.13 | $331.13 | $724.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,230.27 Median $1,230.27 Typical High $2,754.23 | Professional | 54 · Surgery only | $1,230.27 | $1,230.27 | $2,754.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $245.47 Median $245.47 Typical High $549.54 | Professional | 55 · Aftercare only | $245.47 | $245.47 | $549.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $165.96 Median $165.96 Typical High $363.08 | Professional | 56 · Pre-op care only | $165.96 | $165.96 | $363.08 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,148.15 Median $1,148.15 Typical High $2,570.40 | Professional | 78 · Unplanned return to OR | $1,148.15 | $1,148.15 | $2,570.40 |
Where Florida sits
The same service costs 9.8 times more in Alaska than in Kentucky. 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
$1,698
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.